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Background <p>Perianal Crohn’s disease (PCD) represents one of the most severe and refractory forms of pediatric inflammatory bowel disease (IBD). Constipation and colonic redundancy, particularly type 1 dolichocolon (T1-DC), may increase distal rectosigmoid pressure, and exacerbate perianal pathology. We hypothesized that T1-DC is more common in children with PCD than in those with uncomplicated ileocolonic Crohn’s disease (CD) or non-IBD controls.</p> Methods <p>Retrospective electronic medical record search was performed. DC type was determined radiographically using established criteria, focusing on T1- and T2-DC. Constipation history was abstracted from medical records under IRB-approved protocols.</p> Results <p>Twenty consecutive children with PCD [penetrating (B3p) or inflammatory (B1p)] were compared to 20 children with non-complicated ileocolonic CD (L3/B1) and 30 non-IBD trauma controls. DC was significantly more prevalent in PCD than in ileocolonic CD or controls (<i>p</i> &lt; 0.001), primarily due to T1-DC. The associations persisted (<i>p</i> &lt; 0.03) in PCD patients without a history of constipation.</p> Conclusions <p>Rectosigmoid redundancy (T1-DC) may represent an underrecognized anatomic co-morbidity in children with PCD, contributing to increased distal pressure and susceptibility to perianal complications. Identification of T1-DC could inform surgical decision-making and postoperative management. Targeted approaches—such as segmental resection during stoma reversal, structured bowel regimens, physical activity, and pelvic-floor biofeedback—may help reduce recurrence risk. Prospective studies are needed to define the mechanistic role of colonic redundancy in the pathogenesis of PCD.</p>

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Type 1 Dolichocolon as a Potential Anatomic Co-morbidity in Children with Perianal Crohn’s Disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月18日

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  • Richard Kellermayer,
  • Réka G. Szigeti,
  • Marla Sammer,
  • Adam M. Vogel,
  • Harland S. Winter

摘要

Background

Perianal Crohn’s disease (PCD) represents one of the most severe and refractory forms of pediatric inflammatory bowel disease (IBD). Constipation and colonic redundancy, particularly type 1 dolichocolon (T1-DC), may increase distal rectosigmoid pressure, and exacerbate perianal pathology. We hypothesized that T1-DC is more common in children with PCD than in those with uncomplicated ileocolonic Crohn’s disease (CD) or non-IBD controls.

Methods

Retrospective electronic medical record search was performed. DC type was determined radiographically using established criteria, focusing on T1- and T2-DC. Constipation history was abstracted from medical records under IRB-approved protocols.

Results

Twenty consecutive children with PCD [penetrating (B3p) or inflammatory (B1p)] were compared to 20 children with non-complicated ileocolonic CD (L3/B1) and 30 non-IBD trauma controls. DC was significantly more prevalent in PCD than in ileocolonic CD or controls (p < 0.001), primarily due to T1-DC. The associations persisted (p < 0.03) in PCD patients without a history of constipation.

Conclusions

Rectosigmoid redundancy (T1-DC) may represent an underrecognized anatomic co-morbidity in children with PCD, contributing to increased distal pressure and susceptibility to perianal complications. Identification of T1-DC could inform surgical decision-making and postoperative management. Targeted approaches—such as segmental resection during stoma reversal, structured bowel regimens, physical activity, and pelvic-floor biofeedback—may help reduce recurrence risk. Prospective studies are needed to define the mechanistic role of colonic redundancy in the pathogenesis of PCD.