Crohn's Disease: The Complete Guide to Medical Management

Gary R. Lichtenstein, MD, FACP, FACG, AGAF

Chapter 26: Medical Management of Postoperative Recurrence of Crohn’s Disease (continued)

Geert D'Haens, MD, PhD; David N. Moskovitz, MD, FRCP(C)

Endoscopic recurrence occurs early after ileocolonic anastomosis. By means of ileocolonoscopy, endoscopic recurrence can be diagnosed in 50% to 75% of patients at 3 months and in 50% to 90% at 12 months after surgery.3-5 Rutgeerts et al developed an endoscopic scoring system to assess postoperative lesions. The score varies from i0 to i4 (i for ileal) and assesses the severity of the lesions in the proximity of the ileocolonic anastomosis.6 Several trials have demonstrated that the clinical disease course correlated well with endoscopic appearance at a given point.