Key Points
Key Points
➤ Nearly one-half of patients with Crohn's disease (CD) will
require bowel resection within the first 10 years of disease.
• However, surgery is not curative, and one-fourth of these patients
will require at least another bowel resection within five years of index
surgery.
➤ Surgical recurrence is usually preceded by endoscopic and
clinical recurrence. Endoscopic recurrence can occur in the
neoterminal ileum in as many as 90% of patients within 12
months of surgical resection.
• Certain clinical features, such as the presence of penetrating disease,
cigarette smoking, and multiple prior resections, are risk factors for
disease recurrence.
➤ The presence and severity of endoscopic recurrence, as
measured by the Rutgeerts' score, is a strong predictor of
clinical and surgical recurrence.
➤ The prevention of postoperative disease recurrence is a
high priority given the morbidity associated with clinical
and surgical recurrence and the long-term risk of short gut
syndrome that may arise from multiple bowel resections.
