Surgical Treatment of Gastric and Duodenal Fistulas in Crohn's Disease

Kaori Koyama, Iwao Sasaki, Yuji Funayama, Hiroo Naitoh, Yasuhiko Kamiyama, Michinaga Takahashi, Chikashi Shibata, Hideo Segami, Seiki Matsuno

The First Department of Surgery, Tohoku University School of Medicine

We report three patients with Crohn's disease associated with gastric or duodenal enteric fistulas treated by surgery. Two patients had duodeno-colic fistulas, and another had a gastro-colic fistula. Preoperatively, all patients received total parenteral nutrition, and two of them were additionally treated with medical therapy. Although the nutritional status of all patients improved remarkably, fistulae were not closed completely. After conservative therapy, all patients underwent colectomy and resection of the fistulae. They returned to work soon after the surgery and had a good QOL at follow-up periods. Surgical treatment should be recommended in the management of internal fistulas between upper and lower GI tract of Crohn's disease.

Key words
Crohn's disease, gastro-colonic fistula, duodeno-colonic fistula

Reprint requests
Kaori Koyama First Department of Surgery, Tohoku University School of Medicine
1-1 Seiryouchou, Aoba-ward, Sendai, 980 JAPAN

Accepted
June 14, 1993

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