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Crohn’s Disease

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Coloproctology

Part of the book series: European Manual of Medicine ((EUROMANUAL))

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Abstract

The exact etiology of Crohn’s disease remains unclear, but current evidence suggests that the intestinal mucosal barrier is compromised, allowing invasion of intestinal bacteria into the bowel. Conservative measures are the mainstay of treatment. Surgery is primarily used to treat complications of Crohn’s disease and to improve quality of life. Certain situations such as enterovesical fistulas are absolute indications for surgery. In isolated ileocecal Crohn’s disease, primary ileocecal resection is a therapeutic alternative equivalent to the escalation of medical treatment. Adequate preoperative preparation, including improving nutritional status, weaning off or stopping immunosuppressive medication, and preoperatively draining abscesses, can decrease complication rates of surgery for Crohn’s disease. Unless neoplasia is present, bowel-sparing techniques (strictureplasty, limited resections) should be used. The laparoscopic approach is possible for most indications; its superiority over the open approach has been shown for primary ileocecal resection. Seton drainage is a good option to retain quality of life for patients with complex perianal fistulas.

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Authors and Affiliations

  1. Department of Surgery, University Medicine Mannheim, Mannheim, Germany

    Peter Kienle

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  1. Peter Kienle
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Correspondence to Peter Kienle .

Editor information

Editors and Affiliations

  1. End- und Dickdarm-Zentrum Mannheim, Mannheim, Germany

    Alexander Herold

  2. Clinique de chirurgie digestive et endocrinienne, Institut des maladies de l’appareil digestif, Hotel Dieu, Nantes, France

    Paul-Antoine Lehur

  3. Chirurgische Klinik mit Poliklinik, Universitaet Erlangen, Erlangen, Germany

    Klaus E. Matzel

  4. UCD School of Medicine, St Vincent’s University Hospital, Dublin, Ireland

    P. Ronan O'Connell

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Kienle, P. (2017). Crohn’s Disease. In: Herold, A., Lehur, PA., Matzel, K., O'Connell, P. (eds) Coloproctology. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53210-2_15

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  • DOI: https://doi.org/10.1007/978-3-662-53210-2_15

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-53208-9

  • Online ISBN: 978-3-662-53210-2

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