This paper reports the indications for, and results of, excision of the large intestine with
ileostomy in 73 patients with Crohn's
colitis who have been followed for a mean of nine years since resection. Sixty-four of them are still alive and all but two of the survivors are now in good health.However, 23 (33%) have developed recurrent
Crohn's disease since resection. This is higher than that reported in many other series and may be due to differences in the length of follow up, the site and extent of
colonic disease, the age of the patient at the time of excision with
ileostomy, and differences in the pathological interpretation of the diagnosis of
Crohn's disease. The high recurrence rate in this series lends caution to the view that the prognosis after excisional surgery and
ileostomy for Crohn's
colitis is as good as after the same operation for
ulcerative colitis and should influence the decision when the alternative of medical or surgical management are being considered for patients with Crohn's
colitis.