Rutgeerts score to asses endoscopic recurrence in resected Crohn’s disease

Rutgeerts score is an endoscopic scoring system used to assess postoperative disease recurrence in patients with resected Crohn’s.

Score Endoscopic lesions
i0 no lesions
i1 ≤ 5 aphthous ulcers
i2 > 5 aphthous ulcers with normal intervening mucosa or patchy areas of larger lesions or lesions confined to the ileocolic anastomosis
i3 diffuse aphthous ileitis and diffusely inflamed mucosa
i4 diffuse ileal inflammation with large ulcers, nodules and/or stenosis

Scoring is performed at follow-up colonoscopy 6 months after resection. Hyperaemia and oedema alone are not considered as signs of recurrence. A score ≥i2 defines endoscopic recurrence.

A modified Rutgeerts score subdivides i2 lesions into i2a = lesions confined to the ileocolonic anastomosis (including anastomotic stenosis) and i2b = lesions in the neoterminal ileum with normal intervening mucosa.

Reference: Rutgeerts P, Geboes K, Vantrappen G. et al Predictability of the postoperative course of Crohn’s disease. Gastroenterology 1990/ Photo:

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