Indications for Surgical Intervention in Regional Ileitis

An audible tendency exists to disparage the value of surgery in the treatment of regional ileitis. The percentages of recurrences after operation are played up; the fact that surgical procedures serve often as long-term palliative factors is forgotten or not sufficiently emphasized. Operative intervention is often inordinately delayed in order to wait for a "better timing" and to allow Nature to heal a spontaneously incurable malady. The pendulum has swung too far to the right in my own estimation. It is therefore timely to reconsider the life history of the disease—what happens when the malady is allowed to run its natural course—and the success in whole or in part of surgery, or perhaps its failures.

Originally,¹ as described, most of the cases were—and they still remain—in the highest percentage of instances a disease process involving 8, 10, or 12 in. of the distal ileum. Historically the earliest success in