Polymorphic Clinical Presentation of Crohn’s Disease

Abstract

Introduction: The clinical presentation of Crohn’s disease is highly variable and often non‑specific. Manifestations range from asymptomatic forms to severe and complicated presentations. Our objective is to analyze the clinical presentation of Crohn’s disease in a sample of the Moroccan population and compare it with that of other regions around the world. Materials and Methods: We conducted a descriptive retrospective study over an 11-year period, involving a sample of patients diagnosed with Crohn’s disease and followed in the Department of Hepato-Gastroenterology at our University Hospital. Several parameters were analyzed, including age, sex, the circumstances of diagnosis, delay of diagnosis and symptoms. Results: A total of 231 patients were included in the study, with a majority being female (60.6%). The mean age at diagnosis was 31.4 years (ranging from 7 to 68 years). The average delay between symptom onset and diagnosis was 16.7 months. Among the patients, 61% presented with chronic diarrhea as the main symptom, while 46% experienced abdominal pain. Koenig’s syndrome was observed in 20% of the cases, and 14% had ano-perineal manifestations, mainly fistulas, in over 70% of these cases. Extraintestinal manifestations were reported in 19% of patients, with joint involvement being the most common (in over 80% of cases). Furthermore, 17% (n = 39) of patients presented with an initial complication of Crohn’s disease, distributed as follows: 16 cases of intra-abdominal abscess, 12 cases of severe malnutrition, 4 cases of severe acute colitis, and 1 case of intestinal obstruction. Conclusion: The findings of this study highlight the marked variability in the clinical manifestations of Crohn’s disease. Moreover, the significant delay between symptom onset and confirmed diagnosis underscores the need for increased awareness to enable earlier detection and optimal management.