Clinical Analysis Of Crohn’s Disease In The Elderly

Objectives Late-onset Crohn’s disease (CD) may show a distinctive pattern of expression. The aim of our study was to describe the incidence or presentation of CD in the elderly. Methods32CD cases(>60Y) diagnosed in our hospital between March2007and March2012were reviewed retrospectively.Results Among all the new diagnosed CD patients, the elderly CD patients takes a proportion of about7.0%with a diagnosis of definite CD44%,71%of the patients are diagnosed of definite CD after surgery. Abdominal pain (75%), diarrhea (59%) are the most common clinical performance, intestinal obstruction (41%) is the most common complications, most being incomplete bowel obstruction. Bowel lesions involved are mostly in small intestine alone (50%) or small intestine and colon both (44%), few involved colon alone.When involved in small intestine, the most common performance is pure ulcer (33%) or ulcer with bowel stricture (33%) and ulcer with Pebbles kind change(27%), the typical colon lesions are only25%. In patients with indications, proportion of finding small intestinal leisons using capsule and double-balloon enteroscopy are82%and100%respectively, but the proportion of capsule retention is18%, especially in patients with intestinal obstruction before. In active period of CD, average platelet is (242.6±114.1)*109/L, platelet more than300*109/L is seen in5patients (23.8%), elevated CRP is seen in12cases (57.1%). The most common misdiagnosis is appendicitis (30%). Proportion needing surgery (34%) is higher, medicines are still salicylic acid drugs primarily (84%). Conclusions Crohn’s disease in the elderly makes some proportion in the new diagnosed CD patients, clinical manifestations are nonspecific and is easily misdiagnosed as appendicitis, tuberculosis of intestines and other diseases, bowel obstruction is the most common complications, capsule endoscopy is a good way to find small intestinal lesions, but the capsule retention rate is high. Definite diagnosis is difficult, mostly need surgery to diagnose.