BryanN. Brooke

FURTHER ANIMAL EVIDENCE OF A TRANSMISSIBLE AGENT IN CROHN'S DISEASE

Abstract Six New Zealand White rabbits were inoculated intraileally with Crohns tissue homogenates. Granulomatous changes with the presence of focal epithelioid and giant-cell granulomas were observed to evolve in the submucosa and other tissues of the bowel wall and in the draining mesenteric nodes of a proportion of rabbits receiving Crohns homogenates but not in controls inoculated identically with normal ileal homogenate. These experiments suggest that the rabbit will prove to be suitable as an animal model of Crohns disease, and they provide further evidence to support the presence of a transmissible agent.

ILEOSTOMY AND EXCISION OF THE LARGE INTESTINE FOR ULCERATIVE COLITIS

Abstract 442 patients with ulcerative colitis were submitted to an operative programme of ileostomy and removal of the large bowel, between the years 1947 and 1965; of the 85 deaths, 46 were due to operation. Of the 39 late deaths, carcinoma (15 cases) and liver failure (7 cases) were the most common causes. Only 2 of the late deaths were attributable to surgical treatment and were due to obstruction. Initially emergency operation predominated over elective. During the period this position was reversed. A random group of 100 patients (38 men and 62 women) were brought to hospital for review five or more years after surgery. Although the ability to work and enjoy leisure and the state of nutrition was satisfactory in this group an increased infertility was observed in females and sexual disability was noted in the males. A further 62 men were interviewed. The cause of sexual disability seems to be technical failure in removal of the rectum. With experience this should be avoidable. Cancer is a serious risk in patients with disease persisting for ten years. It remains a risk if any part of the large intestine is retained.