Distinct phenotypes of children with perianal perforating Crohn's disease

Scott S. Short, Marla C. Dubinsky, Shervin Rabizadeh, Sharmayne Farrior, Dror Berel, Philip K. Frykman

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose Perianal perforating disease (PF) has been reported in approximately 15% of children with Crohn's disease (CD). It is unknown whether children who present with PF at the time of diagnosis have a different course than those that develop PF while on therapy. Methods From a prospective, single institution observational registry of children diagnosed with CD, we identified children with perianal perforating CD, defined as perianal abscesses and/or fistulae. Patients who presented with perianal perforating CD (PF-CD 0) were compared to those who developed perianal perforating CD (PF-CD1) after initial diagnosis. Results Thirty-eight of 215 (18%) children with CD had PF-CD during a median follow up of 4.5 years. Patients with PF-CD0 (n = 26) tended to be more likely male (81% vs. 50%, p = 0.07) and younger (9.3 yrs vs. 12.5 yrs, p = 0.02). PF-CD1 (n = 12) patients were more likely to require diverting ileostomy (42% vs. 8%, p = 0.02) and colectomy (33% vs. 4%, p = 0.03). Multivariable analysis predicted increased rate of diverting ileostomy in the PF-CD1 group (p = 0.007, OR 19.1, 95% CI 1.6-234.8). Conclusion Pediatric CD patients who develop PF while on therapy for CD have a more severe phenotype and are more likely to require diverting ileostomy or colectomy compared to those who present with PF-CD.

Original languageEnglish (US)
Pages (from-to)1301-1305
Number of pages5
JournalJournal of Pediatric Surgery
Volume48
Issue number6
DOIs
StatePublished - Jun 2013
Externally publishedYes

Keywords

  • Crohn's disease
  • Inflammatory bowel disease
  • Perforating
  • Perianal Crohn's disease
  • Seton

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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