Surgical management of duodenal Crohn's disease

World J Gastrointest Surg. 2023 Jun 27;15(6):1159-1168. doi: 10.4240/wjgs.v15.i6.1159.

Abstract

Background: The case of Crohn's disease involving the duodenum is rare, and its surgical management requires a thorough understanding.

Aim: To investigate the surgical management of duodenal Crohn's disease.

Methods: We systematically reviewed patients diagnosed with duodenal Crohn's disease who underwent surgery in the Department of Geriatrics Surgery of the Second Xiangya Hospital of Central South University from January 1, 2004, to August 31, 2022. The general information, surgical procedures, prognosis, and other information of these patients were collected and summarized.

Results: A total of 16 patients were diagnosed with duodenal Crohn's disease, where 6 cases had primary duodenal Crohn's disease, and 10 had secondary duodenal Crohn's disease. Among patients with primary disease, 5 underwent duodenal bypass and gastrojejunostomy, and 1 received pancreaticoduodenectomy. Among those with a secondary disease, 6 underwent closure of duodenal defect and colectomy, 3 received duodenal lesion exclusion and right hemicolectomy, and 1 underwent duodenal lesion exclusion and double-lumen ileostomy.

Conclusion: Crohn's disease involving the duodenum is a rare condition. Different surgical management should be applied for patients with Crohn's disease presenting with different clinical manifestations.

Keywords: Crohn’s disease; Duodenum; Inflammatory bowel disease; Surgical treatment.