Journal des maladies et troubles inflammatoires de l'intestin

Initial Site of Crohn’s Disease is not an Independent Predictor of Outcome of Short Bowel Syndrome

Abstract

Wheeler MJ, Langenfeld SJ, Lyden E, Weseman RA, Rochling FA and Thompson JS

Objective: Patients with Crohn's disease (CD) are at risk for Short Bowel Syndrome (SBS). Our aim was to determine the effect of initial site of disease on outcome in patients with CD developing SBS. Methods: We reviewed the outcome of 87 adult CD patients with SBS. Thirty-eight (44%) had initial ileocolonic disease, 27(31%) had colonic disease and 22(25%) had small intestinal disease. Results: Compared to patients with small intestinal and ileocolonic disease, patients with initial colonic disease were more likely to have a total colectomy (85% vs 32% and 37%, p<.05) and have an ostomy (89% vs 37% and 34%, p<.05). Intestinal remnant length was similar. Intestinal remnant length was the only predictor of need for longterm(> 1year) Parenteral Nutrition (PN) (p<0.0001). CD site at presentation was not significant on multivariate analysis (p=0.40). Conclusion: Patients with CD with colon as the initial site of disease who develop SBS have different anatomic characteristics. However, initial site of disease is not an independent predictor of need for long-term PN.