Diagnostic and Prognostic Value of Some Typical Morphological Changes in Crohn's Disease
Study Objective: To analyze the frequency that granulomas are detected in patients with Crohn's disease (CD) that affects different parts of the gastrointestinal tract (GIT) and to assess the prognostic value of this histological finding. Study Design: This was a comparative study. Materials and Methods: The study included 187 patients with verified diagnosis of CD (by examining biopsy samples in 163 patients or samples obtained during surgery in 24 patients). We analyzed the history data of these patients, their clinical manifestations and disease phenotypes and assessed the findings obtained from endoscopy reports, and histology of biopsy samples or samples collected during surgery. Results: In 19% of patients, granulomas were detected in biopsy samples, and in 66.7% of patients they were found in samples obtained during surgery. Patients who had granulomas more often had a complicated disease (strictures and penetration) and more frequently required surgical interventions and anticytokine therapies. Conclusion: Granulomas are an important diagnostic sign of CD. Granulomas found in biopsy samples or samples obtained during surgery should be considered as a marker of poor prognosis and the need for more aggressive treatment.