Stricturing duodenal Crohn’s disease (CD) is an uncommon but dangerous form of  CD that causes substantial morbidity. Researchers want to give the first reliable incidence data and case studies on this severe manifestation in youngsters.

Over a 19-year period, a regional cohort of prospectively acquired incident cases of childhood CD diagnosed for patients younger than the age of 16 was collected in South-East Scotland. A retrospective review of all patients’ medical records was performed, as well as a review of the available literature and consensus guidelines. The rates of occurrence of total CD and duodenal stricturing CD were computed.

 

During the research period, 247 new instances of pediatric CD were detected. The median age at diagnosis was 12.5 years, with a male preponderance of 6%. Overall, the incidence rate of pediatric CD was 5.70/100,000/year, with a particular duodenal B2 phenotypic disease incidence rate of 0.05/100,000/year, accounting for 0.8% of incident cases at diagnosis. Two patients with duodenal CD stricturing presented with systemic symptoms of weight loss, abdominal discomfort, anorexia, and tiredness, as well as frequent vomiting indicative of obstruction. Both instances responded somewhat too intense medical treatment but ultimately required surgical gastroduodenostomy. A thorough review of the literature revealed that there are no pediatric incidence statistics, recommendations, or case reports pertaining to duodenal stricture as a presentation or consequence of CD.

Duodenal structuring disorder is an uncommon but dangerous form of CD that causes considerable morbidity and is not yet discussed in pediatric literature or consensus recommendations. Best practices in medical and surgical management are yet unknown, necessitating more study.

Reference:journals.lww.com/jpgn/Fulltext/2019/11000/Incidence_of_Paediatric_Stricturing_Duodenal_Crohn.7.aspx

Author