I.S. Malkov1, V.N. Korobkov1, V.A. Filippov1, M.R. Tagirov1,2, I.N. Yarmushov2, A.M. Zaynutdinov1, Kh.M. Khalilov2, E.A. Simurzin2

1Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan

2City Clinical Hospital №7, Kazan

Malkov Igor S. ― Doct. of Sci. (Med.), Professor, Head of the Department of Surgery of the Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia

36 Butlerov Str., Kazan, 420012, Russian Federation, tel. +7-965-594-40-07, e-mail:, ORCID ID: 0000-0003-2350-5178, Scopus Author ID: 7003868993


Introduction. The issues of diagnosis and treatment of Crohn’s disease remain topical up to the present time.

The aim of the investigation is to study diagnostic peculiarities, differential diagnostics and choice of treatment tactics of patients with Crohn’s disease in a surgical hospital.

Material and methods. The peculiarities of diagnostics and treatment of 48 patients with Crohn’s disease were studied. Ten patients with acute appendicitis and 11 patients with colitis were included as comparison group.

The results of own research. The proposed system of criteria for the differential diagnosis of Crohn’s disease of the ileum and of acute appendicitis and Crohn’s disease of the colon and other types of colitis.

Discussion. At Crohn’s disease of the large intestine the study of the anamnesis, the data of physical and instrumental methods of examination permit to make necessary differential diagnostics before operation and in a number of cases to establish correct diagnosis. Principles of surgical treatment of Crohn’s disease and various kinds of colitis coincided, and indications for surgical intervention in all cases were complications developed at late stages of the disease.

Conclusion. Crohn’s disease is disease with absence of specific symptoms of the disease and tendency to recurrent course with formation of intestinal fistulas and pararectal complications. The greatest diagnostic difficulties are encountered in the early stages of Crohn’s disease. Due to high risk of primary colonic anastomosis failure in advanced stage of Crohn’s disease in most cases two-stage surgical treatment is necessary. One-stage intervention with intestine resection and intestinal anastomosis should be performed in the absence of purulent foci of abdominal cavity, marked infiltrative changes of intestinal wall and peritonitis. It is important to use proximal and distal intestinal loop without inflammatory changes of its wall for intestinal anastomosis formation. Lifelong medication and intestinal monitoring for possible relapse of the disease is indicated in postoperative period.

Key words: Crohn’s disease, acute appendicitis, nonspecific ulcerative colitis, pseudomembranous colitis, postradial colitis, intestinal fistula.