Clinical characteristics and outcome of fistulizing Crohn's disease: One single‐center experience in Taiwan

Abstract

Crohn's disease (CD) is characterized by chronic and/or relapsing immune activation and inflammation within the gastrointestinal tract. Approximately 35% of patients with CD are complicated by fistulae. However, little is known about the incidence and natural history of fistulizing CD in Asia, especially enterocutaneous fistulae (ECF). In this study, we aimed to investigate the clinical course and outcomes of patients with fistulizing CD. We performed a retrospective analysis using the database of Chang Gung Memorial Hospital to analysis the clinical characteristics, clinical course of CD, gender, age, medical and surgical treatment, complications, and long‐term outcomes. From January 1989 to November 2016, 97 patients were enrolled (73 males and 24 females) with a median age at diagnosis of CD of 32 years (average 36.28 ± 15.84 years). All of the patients were classified by Montreal classification. Montreal classifications A2 (age 16‐40 years; n = 56, 57.7%), L3 (ileocolonic type; n = 47, 48.5%), and B1 (nonstricturing and nonpenetrating type; n = 43, 44.3%) were the most common phenotypes. ECF occurred in five patients (5.1%), enterovaginal fistula in three patients (3.1%), and enterovesical fistula in two patients (2.0%). The duration of CD before the onset of ECF was 3.9 years, enterovaginal fistula was 2.5 years, and enterovesical fistula was 5 years, and most of the patients complicated with a fistula required surgical treatment.