Enfermedad Crohn

Updates in Surgery

Roberto Tersigni • Cosimo Prantera (Eds.)

Crohn's Disease
A Multidisciplinary Approach

Foreword by Enrico De Antoni

123

Editors Roberto Tersigni Chief and Chairman Department of Surgery San Camillo-Forlanini Hospital Rome, Italy Cosimo Prantera Professor Emeritus Gastroenterology Unit San Camillo-Forlanini Hospital Rome, Italy

ISBN 978-88-470-1471-8
DOI10.1007/978-88-470-1472-5

e-ISBN 978-88-470-1472-5

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Foreword

In 1761, J.B. Morgagnidescribed the clinical case of a young man who died from an ileal perforation. The patient’s clinical presentation included ileal ulceration and inflammation of the mesenteric lymphonodes with splenomegaly. This was the first description of Crohn’s disease (CD). In 1904, a Polish physician, Lesmowski, wrote a case report for a local medical journal, describing a patient with symptoms similar to thoseof CD. In 1913, an English author, C. Combe, and a Scottish colleague, T.K. Daziel, reported several cases of “chronic interstitial enteritis” with the features of CD. However, these descriptions were completely ignored by the academic world. The pathology became known only after the classic description of Crohn, Ginzburg, and Oppenheimer in 1932. They described a “chronic granulomatousinflammation of the ileal ansa.” Nevertheless, it was only in 1960, after the wellknown publication of Lockhart-Mummery and Morson, that the existence of the disease entity, by then known as CD, was accepted. While CD can affect any part of the digestive tract, without distinction, from the mouth to the anus, it shows very different localizations. The etiopathology of CD remains controversial; the diseasehas a variable clinical presentation and thus a number of therapeutic options, both medical and surgical. However, treatment of the frequent precocious and late complications of CD remains problematic. More recently, research has focused on the immunological origins of the disease, specifically, on the humoral and cell-mediated responses of the immune system to sensitizing agents. Furthermore,environmental factors acting in concert with a genetic predisposition have been considered and may explain the increased incidence of CD in certain geographical areas over the past few decades. The Italian Society of Surgery has recognized the need for an authoritative update on the subject and has entrusted this task to Roberto Tersigni, in recognition of his extensive experience in the field of CD...