How is strictureplasty performed in patients with Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

Strictureplasty for multiple shorter strictures has the benefit of conserving the bowel. A Foley catheter (inflated to 25 mm) can be passed through the lumen to detect additional distal strictures. The strictured bowel is incised longitudinally to a point 1-2 cm beyond the narrowing and then closed transversely without resection.

For long or multiple confluent strictures, a stricturoplasty that resembles a Finney side-to-side pyloroplasty (“essentially a side-to-side gastroduodenostomy” [131] or a “side-to-side anastomosis of antrum and duodenum that … does not exclude the pyloric area” [132] ) can be used to conserve bowel length.

Hydrostatic balloon dilatation of ileocolic strictures has been performed, but its effects may not be long lasting. Bypass procedures are usually reserved for duodenal obstructions. [133, 134]


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