In a patient excision rather than bypass is preferred for surgical treatment of small intestinal Crohn's because:
- Bypass of segments of small bowel affected with Crohn's disease is a safe operation with few complications, and one that usually relieves symptoms promptly. - It leaves diseased bowel behind, however, which can flare in the future and can develop carcinoma. - Excision, though it does not cure the Crohn's disease, removes the areas of severe involvement and so eliminates the risk of developing cancers in these segments - Indications of Surgery in Crohn's disease: Indications in Small intestine Stricture & Obstruction unresponsive to Medical therapy Massive haemorrhage Refractory fistula Abscess Indications in Colon & Rectum Intractable disease Fulminant disease Perianal disease unresponsive to medical management Refractory fistula Colonic obstruction Cancer prophylaxis Colonic Dysplasia or Cancer
Excision is safer.
Bypass does not relieve symptoms.
Excision cures the patient of Crohn's disease but bypass does not.
The risk of small intestine cancer is reduced.
Inflammatory bowel disease