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Canadian Journal of Gastroenterology
Volume 8, Issue 3, Pages 193-198
Clinical Gastroenterology

Risk Factors Predicting Recurrent Small Intestinal Resection for Crohn’s Disease of the Terminal Ileum

Hanna Binder and Hugh J Freeman

Department of Medicine ( Gastroenterology), University of British Columbia and University Hospital, Vancouver, British Columbia, Canada

Received 15 November 1992; Accepted 15 November 1993

Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study examined potential risk factors for recurrent small intestinal resection in a ‘reagent-grade’ group of 94 consecutive patients with prior removal of histologically defined Crohn’s disease localized to the distal ileum seen by one gastroenterologist at a single teaching hospital. There were 38 males and 56 females ranging in age from 15 to 58 years, with an average length of follow-up of 8.7 years. Of these, 26% required a second resection for recurrent small intestinal disease. Cumulative reoperation rates in these 25 patients were 18% at five years and 24% at 10 years. Univariate and multivariate analyses of multiple demographic, clinical, laboratory and pathological variables revealed two apparent statistically significant independent risk factors for a second intestinal resection: steroid treatment, likely an indirect indication of more severe disease activity; and the presence of an internal fistula, consistent with the emerging concept of a relatively more aggressive clinical form of Crohn’s disease.