Pediatric jejunoileitis: A severe Crohn's disease phenotype that requires intensive nutritional management

T. M. Attard, Karen M Horton, K. M. DeVito, A. Darbari, Maria Oliva-Hemker, Richard Thompson, Carmelo Cuffari

Research output: Contribution to journalArticle

Abstract

Background: Jejunoileitis (JI) is an unusual manifestation of Crohn's disease (CD) that has been associated with high morbidity and the frequent need for surgical intervention. Although the disease has been well-described in adults, the true prevalence and clinical phenotype in children is unknown. Aim: To compare the clinical course and nutritional impact of CD in children with and without proximal small bowel involvement. Methods: Patients with either Crohn's jejunitis or JI with or without colonic involvement were identified through a clinical database (1996-2002). All radiologic studies were reviewed by an experienced radiologist blinded to the clinical diagnosis. Thirty-six patients with CD without histologic or radiologic signs of proximal small bowel involvement were used for comparison. All medical, surgical, and hematologic parameters were compared in both disease groups. Results: Among the 134 patients with CD, 23 (17%) had radiologic signs of JI, including intestinal fold thickening (57%), luminal narrowing (31%), and skip lesions (13%). Enteric fistula (6%) and strictures (6%) were less common. Patients with JI were likely to be stunted at the time of diagnosis, require surgical intervention (P <0.03) and nutritional therapy in the form of nasogastric tube feeds (P <0.03). Nutritional therapy was also associated with an improvement in height in patients with proximal small bowel disease (OR:5.87). Discussion: JI is a relatively common disease phenotype in children with CD that requires aggressive nutritional and surgical intervention. Future studies are required to determine if the early detection and use of immune modulators may lessen the morbidity associated with proximal small bowel disease.

Original languageEnglish (US)
Pages (from-to)357-360
Number of pages4
JournalInflammatory Bowel Diseases
Volume10
Issue number4
DOIs
StatePublished - Jul 2004

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Crohn Disease
Pediatrics
Phenotype
Morbidity
Fistula
Pathologic Constriction
Databases
Therapeutics

Keywords

  • Crohn's disease
  • Jejunoileitis
  • Nutritional therapy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Pediatric jejunoileitis : A severe Crohn's disease phenotype that requires intensive nutritional management. / Attard, T. M.; Horton, Karen M; DeVito, K. M.; Darbari, A.; Oliva-Hemker, Maria; Thompson, Richard; Cuffari, Carmelo.

In: Inflammatory Bowel Diseases, Vol. 10, No. 4, 07.2004, p. 357-360.

Research output: Contribution to journalArticle

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