P113. Granuloma is associated with poor outcome in Crohn's disease patients after surgical bowel resection
Y.M. Han1, J.W. Kim2, J.M. Choi1, S.-J. Koh2, C. Lee1, S.H. Kim2, J.P. Im1, 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, South Korea, 2Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, South Korea
Granulomas are one of the histologic features in patients with Crohn's disease. However, little information is available regarding the clinical significance of granulomas in patients with Crohn's disease. The aim of this study is to assess whether the presence of granulomas in resected specimen is associated with disease severity and outcome after surgery.
Patients who underwent surgical bowel resection between 2005 and 2012 in Seoul National University Hospital and SMG-SNU Boramae Medical Center were identified and pathology slides were reviewed for the presence of granulomas. Those patients were divided into two groups according to the presence or absence of granulomas.
Sixty-nine patients were enrolled in this study. According to the presence of granulomas, patients were classified as granuloma group (33 patients, 47.9%) and non-granuloma group (36 patients, 52.1%). Between the two groups, there were no significant difference in age, sex, family history, smoking history, extra-intestinal manifestation (oral stomatitis, cutaneous manifestation, eye manifestation, and arthritis), and clinical presentation (abdominal pain, diarrhea, weight loss, bloody stool, fever). Re-operations were performed more often in the granuloma group (15 cases, 45.5% vs 7 cases, 19.4%, odds ratio = 3.542, p = 0.024). Re-admission and use of immunosuppressant were observed more often in the granuloma group, but there were no significant difference between the two groups.
Granulomas were associated with re-operaton in surgical patients with Crohn's disease. These results suggest that granulomas is one of important factors associated with poor outcome in Crohn's disease.