Abstrakt

Crohn’s disease is characterized by gastrointestinal inflammation, stenosis, and/or fistulae. While fistulae and stenosis affect only 1/3 of Crohn’s disease patients, these are more severely affected and their management is considered to be an interdisciplinary challenge. Diagnostic tests in patients with suspected stenosis are aiming at differentiating inflammatory stenosis from tumor stenosis, complicated stenosis with fistulae and noninflammatory strictures. Both complicated stenosis as well as suspected tumor stenosis are clear indications for operative resection. In contrast, inflammatory stenosis should be treated conservatively, e.g. by corticosteroids. Strictures can be treated either by endoscopic balloon dilatation, operative resection or stricturoplasty. While longer remission rate stands in favor for surgery, endoscopic dilatation is less costly and carries a lower complication rate. Endoscopic dilatations are suitable for short stenosis (at most 10 cm long, better less than 5 cm) in the absence of fistula. Main complications are perforation (on average 4% in published series). Transfusions because of bleeding are extremely rare.

Autoreninformation

Autoren

• F. Freyburger¹
• G. Arling²
• J.C. Hoffmann¹

Abteilungen

• ¹ Medizinische Klinik I, St. Marienkrankenhaus, Ludwigshafen,
• ² Gastroenterologische Praxis, Ludwigshafen

Adresse

Prof. Dr. med. J.C. Hoffmann
Medizinische Klinik I
St. Marienkrankenhaus
Salzburger Straße 15
D–67067 Ludwigshafen
Email: [email protected]

Citation