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A duodenum Crohn-betegsége, klinikai jelek, diagnosztika, gyógyszeres és sebészi kezelés

Lukovich, Péter and Papp, András and Fuszek, Péter and Glasz, Tibor and Győrffy, Hajnalka and Lakatos, László and Harsányi, László (2008) A duodenum Crohn-betegsége, klinikai jelek, diagnosztika, gyógyszeres és sebészi kezelés. Orvosi Hetilap, 149 (11). pp. 505-508. ISSN 0030-6002 (print), 1788-6120 (online)

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Abstract

Duodenal localization of Crohn's disease is rare, accounting for only 0.5-4% of all cases. Most common complaints are gastric outlet obstruction and weight loss. Histologic findings of endoscopic biopsy are frequently not definitive, making differentiation from other, benign structures complicated. There are also no standard guidelines regarding indications for surgical management. PATIENTS AND METHODS: We reviewed the cases of three surgically managed patients with duodenal Crohn's disease at the 1st Department of Surgery, Semmelweis University of Medicine, Budapest, during a 5-year period (2002-2007). All three patients had persistent symptoms of stomach emptying disorder despite medical therapy and had severe weight loss (13-30 kg). In two cases resection of the stenotic duodenum was performed successfully using Billroth II method. Gastro-jejunal bypass was performed in one case, where the descendent duodenum was inflamed. RESULTS: All patients have been asymptomatic since surgery (9-45 months of follow-up) and recovered their earlier bodyweight. The postoperative period was uneventful. CONCLUSIONS: There is indication of surgery in cases of stenosing duodenal Crohn's disease, when medical therapy is not successful, but long-standing malnutrition should be treated preoperatively. We found perioperative morbidity to be similar in patients with duodenal Crohn's and in those with Crohn's disease of other intestinal locations.

Item Type: Article
Subjects: R Medicine / orvostudomány > RC Internal medicine / belgyógyászat
R Medicine / orvostudomány > RD Surgery / sebészet
R Medicine / orvostudomány > RM Therapeutics. Pharmacology / terápia, gyógyszertan
Depositing User: Violetta Baliga
Date Deposited: 05 Apr 2013 10:12
Last Modified: 05 Dec 2019 13:21
URI: http://real.mtak.hu/id/eprint/4620

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