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P202. Long term evolution of small bowel lesions after curative ileo-colon resection in Crohn's disease patients: a prospective follow-up study

E. Corazziari1, N. Pallotta1, G. Vincoli1, D. Piacentino2, 1La Sapienza, Medicina Interna e Specialità Mediche, Rome, Italy, 2Università Sapienza, Neurologia e Psichiatria, Rome, Italy

Background

No systematic prospective study has assessed the long-term evolution of Crohn's disease (CD) small bowel (SB) lesions as evaluations, mainly radiological and endoscopical, performed at the investigators' discretion, were only able to detect luminal alterations; moreover, endoscopy was limited to duodenum and terminal ileum. Small intestine contrast ultrasonography (SICUS) accurately assesses the presence, number, extension and sites of SB transmural and luminal alterations (Pallotta et al. IBD 2005). The aim of the study was to assess the onset and long-term evolution of recurrent CD small bowel lesions by means of SICUS after curative ileo-colonic resection in CD patients.

Methods

Follow-up visits and SICUS were carried out at least yearly for 56.5±35.3 months in 36 operated patients (M 21, age at diagnosis 33.9±14 yrs) not treated with immunosuppressive/biologic therapies. SICUS was performed after the ingestion of 375 ml of macrogol contrast solution.

Results

Recurrent lesions at the level of neo-terminal ileum occurred in 27/36 patients: in 16/27 after ≤12 months with a mean extension of 8.3±9.3 cm, in 3/27 after ≤24 months with a mean extension of 19.8±19.8 cm, in 1/27 after ≤36 months with an extension of 4 cm, in 2/27 after ≤48 months with a mean extension of 4.75±1.8 cm and in 5/27 after >48 months with a mean extension of 2.3±2.5 cm.

Conclusion

Disease recurrence occurred in more than half of the operated patients with ileal CD within the first year. An early recurrence of CD lesions appears to be associated with a greater extension compared to a later recurrence.