Operative Strategy in Recurrent Crohn’s Disease

Crohn’s disease is a panenteric chronic inflammatory disease with an inherent tendency to recur after previous medical or surgical therapy. Indeed, two patients described by Crohn and his associates in their original publication had recurrent disease (1). Most of these recurrences are within the 8- to 10-year period after surgery (2–4). The chronicity of the condition, its ability to recur, and its tendency to affect more than one site in the gastrointestinal system suggest that a conservative approach may be preferable whenever surgery is contemplated. Thus, the patient should be fully informed of potential sequelae from surgery, including recurrence, and the decision to operate should include a risk assessment in which the potential disadvantages of surgery outweigh the status quo.