Strictureplasty of the small bowel in patients with Crohn's disease. An effective surgical option

T. J. Pritchard, D. J. Schoetz Jr, F. P. Caushaj, P. L. Roberts, J. J. Murray, J. A. Coller and M. C. Veidenheimer
Department of Colon and Rectal Surgery, Lahey Clinic Medical Center, Burlington, Mass. 01805.

Fibrotic strictures of the small bowel are known to cause chronic bowel obstruction in patients with Crohn's disease. Strictureplasty without resection permits relief of bowel obstruction and preservation of bowel length. The records of 13 patients who underwent 52 strictureplasties for Crohn's disease at the Lahey Clinic Medical Center, Burlington, Mass, from 1982 through 1989 were reviewed to determine the results of this surgical intervention. Nine patients were treated with strictureplasty only, while the remaining 4 patients underwent concomitant small-bowel resection for stenosed areas not amendable to strictureplasty. One early complication occurred in a patient in whom a pelvic abscess developed. In a median follow-up period of 2 years (range, 0.5 to 7 years), 9 patients were rehospitalized because of obstruction from Crohn's enteritis. Four patients required further surgery, 3 patients underwent strictureplasty at a newly stenosed area of small bowel, and 1 patient required resection of the initial strictureplasty. Strictureplasty is an effective surgical option for patients with Crohn's disease who have symptomatic small-bowel strictures.