Postoperative complications in Crohn’s disease


Abbreviations

CD

Crohn’s disease

ECF

enterocutaneous fistula

ICA

ileocolonic anastomosis

ICR

ileocolonic resection

Introduction

Bowel resection and anastomosis, strictureplasty, and fecal diversion with ileostomy are common surgical treatment modalities for Crohn’s disease (CD). Postoperative complications after any surgery for CD are common, ranging from anastomotic stricture to anastomotic leak. The high risk for the surgery-associated complications may be related to underlying disease process of CD, concurrent immunosuppressive medications, poor nutrition status, and mesenteric fat . In fact, the majority of complications are located at or around anastomosis. The focus of this chapter is long-term complications after surgery. Endoscopic evaluation, along with abdominal imaging, plays an important role in the diagnosis and management of those complications.

Immediate postoperative complications, such as wound infection, ileus, pelvic abscess, or sepsis, are not discussed.

Postsurgical complications after restorative proctocolectomy and ileal pouch for ulcerative colitis are discussed in Chapter 11 , Ulcerative colitis: postsurgical.

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