Gastroenterology MCQ Answer 14

Answer: c

Surgical therapy for Crohn’s disease is curative not palliative, therefore is reserved for complications of the disease or failure of or debilitation, secondary to medical therapy. The lines of bowel resection should be chosen conservatively with only a few centimeters proximally and distally to the site of visible changes of Crohn’s disease. Microscopic evidence of Crohn’s disease at the resection margins does not compromise safe anastomosis and therefore frozen section examination of resection margins is not necessary. In patients with multiple strictures of the small bowel, resection may involve excessive resection of bowel. Therefore, strictureplasty is an appropriate surgical therapy. Long-term results using this approach indicate that recurrence rates are not substantially increased with strictureplasty, even though inflamed intestinal tissue is left in situ. In patients with diffuse disease of the colon or rectum, proctocolectomy with ileostomy is the treatment of choice. Both the risk of ileal involvement and transmural involvement of the rectum precludes the technique of ileal pouch-anal reconstruction in patients with Crohn’s disease.

Category: Gastroenterology MCQs