Disease complications are common indications for surgery in IBD patients. Surgical options will depend on the type of complication. The following table provides a brief overview of some options:

Crohn's Disease

The typical (classic) operation for Crohn's disease not involving the rectum is removal of a diseased segment of the small or large intestine (resection) with subsequent surgically created reconnection (anastomosis). However, some surgeries may result in ostomy.

Medically-refractory disease

  • Resection of the segment with active disease

Intra-abdominal abscess

  • Percutaneous draining by CT-guidance
  • Resection may be necessary

Stricturing

  • Stricturoplasty (for smaller strictures)
  • Resection may be necessary

Fistulization

  • Resection of the segment with active disease
  • Secondary fistula site can be closed up (typically unaffected by CD)

Perianal disease

  • Skin tags are often asymptomatic
  • Fissures/anal ulcers are common but often not painful
  • Abscesses are painful and need to be drained

Fistulas

  • Only symptomatic patients are treated
  • Newer procedures involve using fibrin glue or unique “plugs”

 

Ulcerative colitis

Surgical procedures available to UC patients typically involve removal of the entire colon and rectum (proctocolectomy). There are two types of operations performed after proctocolectomy:

  • Proctocolectomy with ileal pouch anal-anastomosis (IPAA, the most common procedure). The colon and rectum will be removed. A new rectum, an artificial pouch (called a J-pouch), will be fashioned out of your small intestine. The pouch is then connected to the anus.
  • End ileostomy. In this case, there will be the closure of the anus. A stoma will be created in the lower abdomen connecting the small intestine (ileum) to the surface of the body.

 

To learn more about various aspects of surgery in IBD, please, go back to the IBD Surgery main page
References and Acknowledgments