Intestinal obstruction in Crohn's disease in childhood

: Out of 540 children and adolescents from the Multicenter Pediatric Crohn's Disease Study Group, 42 patients presented with decompensated intestinal obstruction. In 26 patients only one intestinal obstruction occurred, and in 16 children up to five intestinal obstructions occurred. Conservative measures were successful in 37 of 72 episodes of intestinal obstruction (51.4%), while 19 of 42 patients underwent emergency surgery (45.2%) and 16 of 42 (38.1%) were operated on following conservative treatment. From analysis of clinical, intraoperative, and histological findings in surgically treated patients, criteria for emergency surgery and elective surgery of intestinal obstruction in Crohn's disease are derived. One patient with adenocarcinoma of the large bowel, presenting with recurrent obstruction, signals caution in delaying proper diagnosis.