Surgical Management of Crohn’s Disease: An Overview

Abstract

Crohn's Disease (CD) is a chronic inflammatory condition of the digestive tract resulting in symptoms such as abdominal pain, weight loss, and fatigue, requiring a multifaceted approach to management. While not curative, the surgical management of CD forms a vital part of the therapeutic strategy for complications. This article overviews various surgical methods for treating CD, their indications, and potential complications. CD predominantly emerges in developed countries, with known risk factors including genetic predisposition, environmental triggers, and diet. The clinical presentation involves varied symptoms based on the inflammation's location within the gastrointestinal tract. Diagnosis necessitates a comprehensive approach, including medical history, physical examination, and diagnostic tests. Surgical intervention may be necessary due to severe complications like intestinal obstruction, abscesses, strictures, fistulas, and perforation. Common reasons for surgery include medically resistant disease and malignancy. However, postoperative recurrence is frequent, necessitating repeated surgery in 26% of cases. This narrative review paper examines three major surgical interventions in detail. Fistulotomy, primarily used for simple fistulas, can offer symptomatic relief in well-selected CD cases but may risk complications and high recurrence rates. Stricturoplasty, useful for widening narrow bowels, preserves intestinal length and function and can serve as an effective alternative to resection. Lastly, the intestinal resection and colectomy procedures are explored, focusing on their indications and complications. Future research should focus on optimizing surgical approaches to reduce recurrence rates and improve patient outcomes.