Crohn's disease associated strictures

J Gastroenterol Hepatol. 2018 May;33(5):998-1008. doi: 10.1111/jgh.14119. Epub 2018 Mar 12.

Abstract

Crohn's disease (CD) is a chronic relapsing and remitting disease that can affect any segments of the gastrointestinal tract. More than 50% of patients with CD develop stricturing or penetrating complications within the first 10 years after diagnosis. Strictures can lead to intestinal obstruction, which is a common indication for surgery. Despite significant advances in the understanding of the pathogenesis of intestinal fibrostenosis, imaging and therapeutic armamentarium of CD, the risk of intestinal surgery remained significantly high. Endoscopic balloon dilation is a promising first-line alternative to surgery as it is less invasive and could preserve intestinal length. In this review, we will evaluate the literature on the mechanism of intestinal fibrosis, emerging imaging techniques, and management strategies for CD associated strictures.

Keywords: Crohn's disease; endoscopic balloon dilation; resection; stricture; strictureplasty.

Publication types

  • Review

MeSH terms

  • Constriction, Pathologic
  • Crohn Disease / complications*
  • Crohn Disease / diagnostic imaging
  • Crohn Disease / pathology
  • Crohn Disease / therapy*
  • Digestive System Surgical Procedures / methods*
  • Dilatation / methods*
  • Endoscopy, Gastrointestinal / methods*
  • Fibrosis
  • Humans
  • Intestinal Obstruction / diagnostic imaging
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / therapy*
  • Intestines / pathology*
  • Risk