European Journal of Pediatrics

, Volume 149, Issue 10, pp 687–690 | Cite as

Acceleration of linear growth following intestinal resection for Crohn disease

  • A. B. Lipson
  • M. O. Savage
  • P. S. W. Davies
  • K. Bassett
  • W. S. Shand
  • J. A. Walker-Smith


Twelve patients with Crohn disease aged from 11.3 to 17.1 years, underwent intestinal resection. Eight were prepubertal or in early puberty and 4 in mid or late puberty. Pre-operative assessment included acceleration and compression barium studies and total colonoscopy. In six patients the surgical indication was failure of medical management and in six intestinal obstruction. All but one were in remission 12 months after surgery. Height velocities in the eight pre and early pubertal patients increased dramatically during 6- and 12-month post operative measurement periods compared with preoperative growth. Height velocities in the mid and late pubertal patients showed much less increase. In selected patients, surgical treatment can induce remission resulting in catch-up growth and sustained growth acceleration. In prepubertal and early pubertal patients surgery is likely to improve final adult height.

Key words

Crohn disease Growth Height velocity Intestinal resection 


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  1. 1.
    Alperstein G, Daum F, Fisher SE, Aiges H, Markowitz J, Becker J, So H, Schwartz D, Silverberg M, Schneider K (1985) Linear growth following surgery in children and adolescents with Crohn's disease: relationship to pubertal status. J Pediatr Surg 20:129–133PubMedGoogle Scholar
  2. 2.
    Bartram CI, Kumar P (1981) Techniques of radiological examination. In: Clinical radiology in gastroenterology. Blackwell, Oxford, pp 1–49Google Scholar
  3. 3.
    Cameron N (1978) The methods of auxological anthropometry. In: Faulkner F, Tanner JM (eds) Human growth. Plenum Press, New York, pp 35–87Google Scholar
  4. 4.
    Frey CF, Weaver DK (1972) Colectomy in children with ulcerative and granulomatous colitis. Arch Surg 104:416–423PubMedGoogle Scholar
  5. 5.
    Greenstein AJ, Sachar DB, Pasternack BS, Janovitz HD (1975) Reoperation and recurrence in Crohn's colitis and ileo colitis: crude and cumulative rates. N Engl J Med 293:685–690PubMedGoogle Scholar
  6. 6.
    Guttman FJ (1974) Granulomatous enterocolitis in childhood and adolescence. J Pediatr Surg 9:115–121CrossRefPubMedGoogle Scholar
  7. 7.
    Homer DR, Grand RJ, Kolodny AH (1977) Growth course and prognosis after surgery for Crohn's disease in children and adolescents. Pediatrics 59:717–725PubMedGoogle Scholar
  8. 8.
    Kelts DG, Grand RJ, Shen G, Watkins JB, Werlin SL, Boehan EC (1979) Nutritional basis of growth failure in children and adolescents with Crohn's disease. Gastroenterology 76:720–727PubMedGoogle Scholar
  9. 9.
    Kirschner BS, Voinchet O, Rosenberg IH (1978) Growth retardation in inflammatory bowel disease. Gastroenterology 75:504–511PubMedGoogle Scholar
  10. 10.
    Kirschner BS, Klich JR, Kalman SS, Defavaro MV, Rosenberg IH (1981) Reversal of growth retardation in Crohn's disease with therapy emphasising oral nutritional institution. Gastroenterology 80:10–15PubMedGoogle Scholar
  11. 11.
    MacDonald TT, Spencer J, Viney JL, Williams CB, Walker-Smith JA (1987) Selective biopsy of human Peyer's patches during ileal endoscopy. Gastroenterology 93:1356–1362PubMedGoogle Scholar
  12. 12.
    Motil KJ, Grand RJ (1988) Inflammatory bowel disease in children and adolescents. Current Concepts Gastroenterol 11: 3–7Google Scholar
  13. 13.
    Motil KJ, Grand RJ, Maletskos CJ, Young VR (1982) The effect of disease, drug and diet on whole body protein metabolism in adolescents with Crohn's disease and growth failure. J Pediatr 101:345–351PubMedGoogle Scholar
  14. 14.
    Preece MA, Law CM, Davies PSW (1986) The growth of children with chronic paediatric disease. Clin Endocrinol Metab 15:403–473CrossRefGoogle Scholar
  15. 15.
    Rosentahl SR, Snyder JD, Hendricks KM, Walker WA (1983) Growth failure and inflammatory bowel diseases: approach to treatment of a complicated adolescent problem. Pediatrics 72:481–490PubMedGoogle Scholar
  16. 16.
    Sanderson IR, Udeen S, Davies PSW, Savage MO, Walker-Smith JA (1987) Remission induced by an elemental diet in small bowel Crohn's disease. Arch Dis Child 62:123–127PubMedGoogle Scholar
  17. 17.
    Strobel CT, Burne NJ, Ament ME (1979) Home parenteral nutrition in children with Crohn's disease: an effective management alternative. Gastroenterology 77:272–279PubMedGoogle Scholar
  18. 18.
    Tanner JM (ed) (1962) The development of the reproductive system. Growth at adolescence, 2nd edn. Blackwell, Oxford, p 39Google Scholar
  19. 19.
    Tanner JM, Whitehouse RH, Cameron N, Marshall WA, Healy MJR, Goldstein H (1983) Assessment of skeletal maturity and prediction of adult height, 2nd edn. Academic Press, LondonGoogle Scholar
  20. 20.
    Whitington PF, Barbes HV, Bayless TM (1977) Medical management of Crohn's disease in adolescence. Gastroenterology 72:1338–1344PubMedGoogle Scholar
  21. 21.
    Wesson DE, Shandling B (1981) Results of bowel resection of Crohn's disease in the young. J Pediatr Surg 16:449–452PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • A. B. Lipson
    • 1
  • M. O. Savage
    • 2
  • P. S. W. Davies
    • 2
  • K. Bassett
    • 2
  • W. S. Shand
    • 3
  • J. A. Walker-Smith
    • 1
  1. 1.Department of Paediatric GastroenterologySt. Bartholomew's HospitalLondonUK
  2. 2.Department of Child HealthSt. Bartholomew's HospitalLondonUK
  3. 3.Department of SurgerySt. Bartholomew's HospitalLondonUK

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