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Surgery for Crohn's Disease

Surgical approaches for medically refractory or complicated Crohn's disease.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Surgery for Crohn's Disease?

Crohn's disease is a chronic transmural (full-thickness) inflammatory disease that may involve any segment of the gastrointestinal tract from mouth to anus. About 70-80% of patients require surgical treatment at least once in their lifetime. Although surgery does not cure the disease, it plays a vital role in managing complications and controlling symptoms.

Surgical indications include disease unresponsive to medical therapy, fibrotic strictures (bowel obstruction), enterocutaneous or enteroenteric fistulas, intra-abdominal abscesses, free perforation, massive bleeding, and suspected malignant transformation. In pediatric cases, growth retardation is an additional indication.

The surgical principle is a 'bowel-preserving' approach. Wide resection is avoided; strictureplasty (bowel-widening technique) is preferred for strictures. Because recurrence is common, prophylactic medical therapy is required postoperatively. The Kendol-Ruther classification and Rutgeerts score are used in recurrence follow-up.

Symptoms

Abdominal pain and cramping
Chronic or bloody diarrhea
Weight loss, fatigue, and growth retardation (in children)
Bowel obstruction (nausea, vomiting, abdominal distension due to stricture)
Perianal disease: fistula, fissure, and abscess
Fever, anorexia, and anemia
Extraintestinal findings: joint pain, skin lesions, uveitis

Risk Factors

Young adult age (15-35)
Smoking (worsens Crohn's disease)
Family history of inflammatory bowel disease
Genetic susceptibility (NOD2/CARD15)
Northern European and Ashkenazi Jewish ethnicity
Diet high in refined sugars and Western pattern
Early appendectomy history (may be protective or risk factor)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Signs of bowel obstruction: severe abdominal pain and distension
  • Abdominal pain and diarrhea unresponsive to medical therapy
  • Perianal abscess or fistula requiring drainage
  • Acute abdomen and peritonitis findings
  • Recurrent symptoms and weight loss

Treatment Methods

01
Segmental resection and primary anastomosis: most common technique
02
Strictureplasty (Heineke-Mikulicz, Finney): bowel-preserving for short strictures
03
Ileocolic resection: for terminal ileum involvement
04
Excision of fistula tract and resection of involved segment
05
Percutaneous drainage of abscess followed by elective surgery
06
Postoperative biologic agent (anti-TNF) prophylaxis and regular colonoscopic recurrence surveillance

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.