Clinical Presentation and Course of Crohn's Disease in Southeastern Ontario

Clinical records of 222 patients with proven Crohn's disease identifiedat Queen's University Medical School in Kingston, Ontario from 1966 to 1984 werereviewed. Four clinical patterns were identified. Ileocolic disease (44%) was mosttrequent. Small intestinal involvement alone occurred in 30% while colonicinvolvement alone was documented in 18%. Gastroduodenal Crohn's disease wasdiagnosed in 8.5%, but in all such patients there was involvement of additional smallor large bowel. Females (57%) out-numbered males (43%) with a female to male ratioof 1.3. The age range at diagnosis was seven to 73 years and 177 patients (80%) werediagnosed between the ages of 11 and 40 years. Patients with colonic disease onlytended to be older and had fewer obstructive episodes, fewer surgical resections andmore gross rectal bleeding. Patients with gascroduodenal disease were more oftenmale, usually had additional small bowel involvement, experienced more localcomplications and required more surgical intervention than the ocher patterns. Onlyone patient was identified with disease restricted to the anorectum. Patients in thisseries were followed from two months to 24 years. The mean duration of follow-upwas 4.9 years. The frequency of complications and the necessity for surgery weresimilar to other reported series. None of the patients had either large or small bowelcancer during the follow-up period and there were no deaths related directly toCrohn's disease, its complications or related surgery