Pseudo-Crohn's disease

Abstract

Fistulization and abscess formation are hallmarks of Crohn’s disease. It is axiomatic that the development of these complications in patients previously operated on represents prima facie evidence of recurrence of inflammatory bowel disease. Many investigators have demonstrated that Crohn’s disease has a high incidence of recurrence after operation, especially if patients are followed up for ten to fifteen years [I]. Despite the frequency of recurrence, most patients with Crohn’s disease ultimately require operation for complications of the disease and for chronic invalidism [2], a position justified by the long symptom-free intervals produced by surgical therapy 131. Because of the complications of the primary disease such as abscess and fistula, postoperative morbidity tends to be higher in these difficult cases than in other types of uncomplicated intestinal operations. We have encountered ten patients during the past eight years in whom postoperative complications masqueraded as recurrent Crohn’s disease. In many instances morbidity was prolonged for months or years because the symptoms were falsely attributed to recurrent disease. Correction of the complication usually led to complete rehabilitation of the patient.