Intestinal fistulas in Crohn disease

BACKGROUND: Only a part of patients suffering from Crohn's disease has enteric fistulae and a different behaviour of Crohn's disease with fistulae is reported in the literature. Aim of this paper is to evaluate if enteric fistulae are a factor conditioning mortality, morbidity and overall postoperative course, in patients with Crohn's disease. METHODS: Data on the postoperative course of 126 laparotomies for Crohn's disease, performed between November 1993 and July 1998, have been prospectively examined. Moreover, the presence of enteric fistula has been evaluated during surgery. RESULTS: Out of 126 interventions, in 58 (46%) enteric fistulae were present. Mortality (5.2% vs 0), morbidity (14.5% vs 7.3%), necessity for a temporary ostomy (20.4% vs 3.5%) were greater in those patients with fistula, as compared as those without fistula. CONCLUSIONS: In conclusion, it is suggested that Crohn's disease with fistulae is a different type of disease, with higher mortality and morbidity rates.