Intestinal Obstruction Due to Ileotransverse Anastomosis Stenosis Secondary to Crohn's Disease: A Case Report
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Abstract
Introduction: Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract. This report explores a case of intestinal obstruction resulting from stenosis of ileotransverse anastomosis, secondary to Crohn's disease.
Epidemiology: The macroscopic features of Crohn's disease vary, including patchy inflammation, ulcers, and stenosis. Stenosis is a common occurrence, particularly in the terminal ileum, affecting 30-40% of individuals with Crohn's disease. OBJECTIVE: To describe a clinical case of intestinal obstruction due to ileotransverse anastomosis stenosis secondary to Crohn's disease, aiming to recognize its behavior and determine surgical management in patients with a high suspicion of this condition.
Patient and Method: A 35-year-old female diagnosed with ankylosing spondylitis, recent Crohn's disease, and intestinal obstruction. Surgical history includes exploratory laparotomy, right hemicolectomy, and ileotransverse anastomosis due to acute appendicitis. Current symptoms led to surgical exploration, revealing extensive adhesions and stenosis at the anastomosis.
Results: The patient underwent resection of the affected intestinal segment and the creation of a terminal ileostomy, successfully resolving the obstruction. Comprehensive preoperative evaluation, diagnostic confirmation through imaging, and appropriate surgical intervention played critical roles in achieving a positive outcome.
Discussion: The discussion emphasizes the complexities associated with Crohn's disease surgery, highlighting common complications such as infection, fistulas, and anastomotic stenosis. The case underscores the need for a cautious surgical approach and the importance of early consideration of Crohn's disease in patients with intestinal obstruction.
Conclusions: This case report underscores the significance of recognizing Crohn's disease in patients presenting with intestinal obstruction. Appropriate surgical management, though challenging due to the heightened risk of complications, is essential for improving treatment outcomes. A comprehensive approach, from timely diagnosis to surgical intervention, is crucial for effectively addressing Crohn's disease manifestations and enhancing patient quality of life.
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doi:10.1016/j.ciresp.2020.08.001