Role of the granuloma in recurrent Crohn's disease.

The clinical significance of sarcoid-like granulomata in recurrent Crohn's disease has been investigated in 90 patients. The recurrence rate for non-granulomatous disease was double that of granulomatous disease. In granulomatous disease, involvement of the mesenteric lymph nodes did not affect the recurrence rate. This suggests that sarcoid-like granulomata reflect the patients' immune response and support the view that excision of the lymphatic drainage en bloc with affected bowel is not indicated.