[The role of conservative surgery in Crohn disease: practical results obtained from a case]

The 42 years old male patient in a 12 year period got over seven laparotomies and repeated bowel resections, due to which there was left only about 50 cm long jejunum, grossly dilatated and connected side to side to the transverse colon after a right hemicolectomy. The patients was admitted in a serious state of malnutrition due to a Y-shaped fistula formation between the too long blind end of the jejunotransversostomy and the first part of the jejunum. The blind end was resected and the 2 holes on the jejunum was closed by one layer wire stitches. The histology demonstrated a typical granulomatosis process. In summary: the Crohn's disease cannot be cured by surgical means. In this panalimentary process the repeated small bowel resections imply a later short bowel syndrome. On the base of the literature and of their modest experience the authors emphasize the need of conservative surgery and for the so called skip-lesions only stricture plasties to be performed instead of resections.