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Gallstone Disease and Related Risk Factors in Patients With Crohn Disease
Analysis of 330 Consecutive Cases
Mirella Fraquelli, MD, PhD;
Alessandra Losco, MD;
Stefania Visentin, MD;
Bruno Mario Cesana, MD;
Roberta Pometta, MD;
Agostino Colli, MD;
Dario Conte, MD
Arch Intern Med. 2001;161:2201-2204.
Background The reported prevalence of gallstone disease (GD), defined as current
gallstones or previous cholecystectomy for gallstones, in patients with Crohn
disease ranges from 13% to 34%. The aim of this study was to characterize
the still undefined risk factors of this complication.
Methods A total of 330 consecutive patients with Crohn disease (189 males and
141 females aged 17-82 years, mean ± SD age, 41 ± 14 years)
underwent liver ultrasonography.
Results A diagnosis of GD was made in 78 patients (24%), 54 with current gallstones
and 24 who had undergone previous cholecystectomy. Its frequency was comparable
in males and females (23% vs 25%), but was significantly associated with age
(P = .001), being 13%, 36%, and 51% in patients aged
44 years and younger, 45 to 59 years, and 60 years and older, respectively
(P = .001). Its prevalence significantly differed
according to the site of the disease at diagnosis (P
= .02) and was unrelated to disease duration. Gallstone disease was more frequent
in patients who had undergone surgery (34% vs 14%; P
= .001) and was significantly associated with the number (P = .001) and site of bowel resections (P
= .001), increasing from 28% in the patients who had undergone 1 resection
to 53% in those having had 2 or more resections (P
= .005) and being significantly higher in patients with a resection involving
the ileocecal region. Multivariate analysis showed that age; site of disease
at diagnosis; and the presence, number, and site of bowel resections were
significantly related to GD.
Conclusions In patients with Crohn disease, the frequency of GD is significantly
higher than that reported in the general population with comparable characteristics
(z = 5.04, P<.001). Age;
site of disease at diagnosis; and the history, number, and site of bowel resections
are independently associated with GD.
From the Postgraduate School of Gastroenterology (Drs Fraquelli, Losco,
Visentin, Pometta, and Conte) and Epidemiology Unit (Dr Cesana), IRCCS Ospedale
Maggiore, Milan, Italy; and the Department of Internal Medicine II, Ospedale
A. Manzoni, Lecco, Italy (Dr Colli).
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