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Related Experiment Videos

Duodenal Crohn's Disease.

Amy L Lightner1

  • 1Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota.

Inflammatory Bowel Diseases
|February 21, 2018
PubMed
Summary

Symptomatic duodenal Crohn's disease (CD) is rare, often presenting as strictures. While medical and endoscopic treatments are options, optimal management strategies for this uncommon condition require further definition.

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Area of Science:

  • Gastroenterology
  • Inflammatory Bowel Disease
  • Surgical Gastroenterology

Background:

  • Symptomatic duodenal Crohn's disease (CD) is an uncommon presentation, frequently manifesting as strictures.
  • Many patients are asymptomatic, leading to incidental diagnosis via imaging or endoscopy.
  • Current medical management involves proton pump inhibitors, corticosteroids, immunomodulators, and biologics.

Purpose of the Study:

  • To review the presentation, diagnosis, and management of symptomatic duodenal Crohn's disease.
  • To discuss current medical, endoscopic, and surgical treatment options.
  • To highlight the need for defined treatment algorithms due to limited evidence.

Main Methods:

  • Literature review of symptomatic duodenal Crohn's disease.
  • Analysis of diagnostic modalities including cross-sectional imaging and endoscopy.
  • Evaluation of medical, endoscopic, and surgical treatment strategies.

Main Results:

  • The most common duodenal CD phenotype is stricturing.
  • Symptomatic strictures can often be managed non-surgically.
  • Surgical interventions include resection, bypass, and strictureplasty.

Conclusions:

  • Optimal treatment algorithms for duodenal Crohn's disease are subjective and undefined due to limited evidence.
  • Medical and endoscopic approaches are viable for symptomatic strictures.
  • Further research is needed to establish evidence-based treatment guidelines.

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