Pediatric Crohn's disease

Abstract

This paper reviews our 10 year clinical experience (1974 to 1983) with 33 patients with Crohn's disease; eight were diagnosed during the first five years and 25 during the second five years of the review. There were only 10 patients with ulcerative colitis during this period. The median age of diagnosis was 13 years, range 6 to 16 years. The main presenting clinical features were abdominal pain (29 patients), weight loss (26 patients), and diarrhea (23 patients). The method of diagnosis included radiological investigations and fiberoptic endoscopy with biopsy. The colon was involved in 20 patients. The therapy included Salazopyrine, steroids, parenteral nutrition (11 patients) including home parenteral nutrition (seven patients) and surgery (13 patients). Significant weight gain was observed in patients after intestinal resection. There were no deaths. We conclude that the incidence of pediatric Crohn's disease appears to be increasing, is more common than ulcerative colitis, and requires surgical treatment in a high proportion of patients. In our experience these patients respond well to aggressive nutritional therapy including home parenteral nutrition and carefully selected surgical treatment.