SURGICAL TREATMENT OF CROHN'S DISEASE

F.Belabbes*, K.Benjouad, K.Gharbi, S.Oubaha, Z.Samlani, K.Krati
Page No. 34-46

Crohn's disease is a chronic inflammatory condition that can affect any segment of the digestive
tract. Its etiology is unknown and its management is multidisciplinary.The treatment of Crohn's
disease is mainly medical, but surgery remains necessary in the majority of cases. This surgery is
reserved for complicated forms orresistant to medical treatment. This work consists in a
retrospective study of a serie of 106 patients undergone surgery for Crohn’s disease, collected in the
department of hépatogastro-enterology , in the CHU Mohammed VI of Marrakech. Over a period of
thirteen years from January 2004 to September 2018. The average age of our patients was 35 years.
with extremes from 17 to 70, with a male predominance with a sex ratio of 1.4. The indication of
surgery was a stenosis symptomatic in 64,1% of cases, a digestive fistula in 14,1% of cases and an
association of the both in 12% of cases. The indication for surgery was urgently asked for 10% of
patients, For 3 patients, this was a table of appendicitis (3%), for 3 patients it was an acute
intestinal obstruction (3%), a deep abscess in two patients (2%) and peritonitis was the surgical
indication in 2 patients (2%). The surgical procedure consisted of ileocecal resection in 40 patients,
ie 37.7% of cases. Right hemi colectomy was performed in 18 patients (16.9%) and hailectomy in
10 patients (9.4%). The postoperative complications found in our series were anastomotic fistula in
only one case, with two cases of septic shock death. Three cases of infection of the wall, and one
case of incisional hernia. In addition, no case of surgical recurrence was noted. Maintenance
treatment was given to immunosuppressive agents in 86% of our patients, and derivatives in 14%,
or to prevent postoperative relapses.
Keywords : Crohn's disease - Surgery - Bowel resection Postoperative recurrence - Maintenance
treatment.