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The Incidence and Natural History of Perianal Fistulas in Korean Patients with Crohn's Disease
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Ja Young Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Seung-Jae Myung, Jae-Won Choe, Ji-Yun Jo, Dong-Hoon Yang, Yun Kyung Cho, Jin-Ho Kim
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Intest Res 2006;4(1):22-31. Published online June 30, 2006
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 Abstract
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- Background/Aims
We performed this study to investigate the incidence and natural history of perianal fistulas in Korean patients with Crohn's disease (CD). Methods: A total of 546 patients diagnosed with CD at Asan Medical Center were included. Results: Perianal fistulas occurred in 265 patients (48.5%), with 355 episodes. Eighty-two patients (15.0%) initially presented with perianal fistulas in the absence of other symptoms suggestive of CD. Out of 265 patients who developed perianal fistulas, 205 (77.4%) presented with perianal fistulas before, or at the time of, the diagnosis of CD. The cumulative incidence of perianal fistulas at 1, 5, 10, 20 years was 40.7%, 48.2%, 55.3% and 62.1%, respectively. Medical treatment was done in 30.7%, and surgery in 80.8% of perianal fistulas. The remission rate was 23.9% with medical treatment, and 83.6% with surgery. At least 1 recurrent fistula occurred in 77 patients (29.1%). The cumulative recurrence rate of perianal fistulas at 1, 5, 10, 20 years was 10.1%, 26.9%, 42.4% and 68.8%, respectively. Conclusions: The incidence of perianal fistulas in Korean patients with CD appears to be higher than that of Western patients. Also, the proportion of patients who develop perianal fistulas before the diagnosis of CD is very high. Therefore, we should consider the possibility of CD in patients with perianal fistulas to manage them properly, and thereby to reduce there complications. (Intestinal Research 2006;4:22-31)
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Clinical Manifestations and Course of Intestinal Behet's Disease: An Analysis in Relation to Disease Subtypes
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Dae-Kyoum Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Seung-Jae Myung, Ji-Yun Jo, Kee Don Choi, Gin Hyug Lee, Hwoon-Yong Jung, Weon-Seon Hong, Jin-Ho Kim, Young Il Min, Chang Sik Yu
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Intest Res 2005;3(1):48-54. Published online June 30, 2005
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Abstract
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- Background/Aims
Intestinal Behet's disease (BD) is one of the main causes of morbidity and mortality of BD because it frequently results in serious complications such as perforation and bleeding. But clinical course of intestinal BD is not well-known. The aim of this study was to review clinical manifestations of intestinal BD, and to compare clinical findings of complete and incomplete types with those of suspected type. Methods: From June 1989 to January 2005, 87 patients who had colonoscopic evidence of intestinal BD and met the criteria proposed by BD Research Committee of Japan were enrolled in this study. Clinical manifestations were collected by retrospective review of medical records. Results: Mean age at diagnosis was 38.4 years (14-66) and sex ratio was 2：1. Abdominal pain was the most frequent gastrointestinal symptom. A single, round ulcer localized at the ileocecal area was the most common colonoscopic finding. Cumulative incidence of first and second operation in 10 years was 30.9% and 38.2%, respectively. Clinical manifestations of suspected type were not different from those of complete and incomplete types. Conclusions: Long-term follow up and close observation is needed for patients with intestinal BD. Although suspected type does not meet the criteria proposed by International Study Group for BD, it should be considered as BD. (Intest Res 2005; 3:48-54)
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