Recurrent Ileitis with Penetrating Sinuses and Recurrent Ileitis with Fistula

Recurrence of Crohn’s disease in the small intestine after surgical resection usually presents with some degree of thickening of the bowel wall and narrowing of the lumen. In some patients, however, this is not the main cause of symptoms. Penetrating sinuses resulting in abscess and fistula formation are responsible for the presenting symptoms and the need for reoperation. If the sinuses do not penetrate the bowel wall, then the symptoms of obstruction may predominate, while deeply penetrating sinuses will give rise mesenteric and retroperitoneal abscesses and fistulas to adjacent organs.