Objectives: We performed a pathological pilot study to characterize the inflammation at the ileocolic anastomosis as Crohn’s disease or ischemia. Methods and materials: Subjects were selected at random from a retrospective database of patients with Crohn’s disease and who had undergone an ileocolic resection with subsequent endoscopic assessment of the anastomosis and neo-terminal ileum. Pathology slides from the anastomotic mucosa, either from targeted biopsies or subsequent ileocolic resections, were re-assessed histologically for features of ischemia and of Crohn’s disease. Results: Twenty-nine specimens from 8 patients were reviewed, including 12 ileocolic resection specimens and 17 sets of endoscopic biopsies. Twenty-seven of the 29 specimens, accounting for all of the patients, had evidence of CD-like features. In contrast, only 2 specimens, accounting for 2 of 8 patients, had histologic features of ischemia, and both specimens also had Crohn’s-like features. Conclusion: To our knowledge this is the first study to specifically evaluate the pathology of ileocolic anastomoses in Crohn’s disease. It suggests that anastomotic inflammation is predominantly a manifestation of recurrent Crohn’s disease rather than of postoperative ischemia.

Original languageEnglish
Pages (from-to)795-799
Number of pages5
JournalScandinavian Journal of Gastroenterology
Issue number7
StatePublished - 2 Jul 2020


  • Crohn’s disease
  • histology
  • pathology
  • post-operative


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