| 摘 要： | AIM:To know the epidemiology and outcome of Crohn'sdisease at King Khalid University Hospital,Riyadh,Saudi Arabiaand to compare the results from other world institutions.METHODS:A retrospective analysis of patients seen for20 years (between 1983 and 2002).Individual case recordswere reviewed with regard to history,clinical,findings fromcolonoscopy,biopsies,small bowel enema,computerizedtomography scan,treatment and outcome.RESULTS:Seventy-seven patients with Crohn's diseasewere revisited,13% presented the disease in the first 10 yearsand 87% over the last 10 years.Thirty-three patients (42.9%)were males and 44 (57.1%) were females.Age rangedfrom 11-70 years (mean of 25.3±11.3 years).Ninety-two(92%) were Saudi.The mean duration of symptoms was26±34.7 mo.The mean annual incidence of the diseaseover the first 10 years was 0.32∶100000 and 1.66∶100000over the last 10 years with a total mean annual incidenceof 0.94∶100 000 over the last 20 years.The chief clinicalfeatures included abdominal pain,diarrhea,weight loss,anorexia,rectal bleeding and palpable mass.Colonoscopicfindings were abnormal in 58 patients (76%) showing mostlyulcerations and inflammation of the colon.Eighty ninepercent of patients showed nonspecific inflammation withchronic inflammatory cells and half of these patientsrevealed the presence of granulomas and granulations onbowel biopsies.Similarly,69 (89%) of small bowel enemaresults revealed ulcerations (49%),narrowing of the bowellumen (42%),mucosal thickening (35%) and cobblestoneappearance (35%).CT scan showed abnormality in 68(88%) of patients with features of thickened loops (66%)and lymphadenopathy (37%).Seventy-eight percent ofpatients had small and large bowel disease,16% had smallbowel involvement and only 6% had colitis alone.Of thetotal 55 (71%) patients treated with steroids at some pointin their disease history,a satisfactory response to therapywas seen in 28 patients (51%) while 27 (49%) showedrecurrences of the condition with mild to moderatesymptoms of abdominal pain and diarrhea most of whichwere due to poor compliance to medication.Seven patients(33%) remained with active Crohn's disease.Nine (12%) patients underwent surgery with resections of some partsof bowel,2 (2.5%) had steroid side effects,6 (8%) withperianal Crohn's disease and five (6.5%) with fistulae.CONCLUSION:The epidemiological characteristics ofCrohn's disease among Saudi patients are comparable tothose reported from other parts of the world.However theincidence of Crohn's disease in our hospital increased overthe last 10 years.The anatomic distribution of the diseaseis different from other world institutions with less isolatedcolonic affection.
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