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Surg Clin North Am. 2015 Dec;95(6):1183-93, vi. doi: 10.1016/j.suc.2015.07.004. Epub 2015 Oct 21.

Crohn's Disease of the Foregut.

Author information

1
Colon and Rectal Surgery, Department of Surgery, William Beaumont Army Medical Center, 4756 Loma de Plata Drive, El Paso, TX 79934, USA. Electronic address: kurtdavis88@gmail.com.

Abstract

Crohn's disease of the foregut is more common than previously recognized, with up to 40% of patients with Crohn's disease in the distal intestine also having evidence of foregut disease. Esophageal disease is best managed medically with proton pump inhibition, steroids, thiopurines, methotrexate, and anti-tumor necrosis factor-α biologic medications. Esophageal strictures are dealt with using endoscopic dilation. Surgery is generally reserved of resistant strictures or esophageal fistulas. Patients with gastroduodenal disease more commonly come to surgery. The most commonly performed operations for gastroduodenal Crohn's disease are intestinal bypass or strictureplasty. The concomitant use of vagotomy remains controversial.

KEYWORDS:

Crohn’s disease; Esophagus; Foregut; Gastric

PMID:
26596921
DOI:
10.1016/j.suc.2015.07.004
[Indexed for MEDLINE]

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