[Management of ileal stenosis in patients with Crohn's disease]

Gastroenterol Clin Biol. 2009 Oct;33(10-11 Suppl):F75-81. doi: 10.1016/j.gcb.2009.07.024. Epub 2009 Sep 4.
[Article in French]

Abstract

Stenosis is the most frequent complication during Crohn's disease. The lesion can be inflammatory, or due to a fibrosing or neoplastic process. The medical treatment with anti-inflammatory drugs is usually sufficient as first line treatment; fibrous lesions require endoscopic or surgical procedures while neoplastic lesions require surgery. A multidisciplinary approach (radiologic, medical, surgical and endoscopic) is needed. In a first part, we discuss the definition of stenosis and the modalities of imaging (particularly MRI) and of treatment (particularly with TNFalpha antagonists). Then we expose the strategy for the management of the most frequent clinical situations: occlusion, ileal inflammatory stenosis, stenosis of an ileocolonic anastomosis and chronic fibrous stenosis. The treatment decision takes into account the results of radiological assessment, CRP level and the effects of the previous treatments.

Publication types

  • English Abstract

MeSH terms

  • Crohn Disease / complications*
  • Crohn Disease / diagnosis
  • Crohn Disease / therapy*
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Glucocorticoids / therapeutic use
  • Humans
  • Ileal Diseases / diagnosis
  • Ileal Diseases / etiology*
  • Ileal Diseases / therapy*
  • Immunosuppressive Agents / therapeutic use
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / therapy*
  • Laparoscopy*
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Immunosuppressive Agents