抄録
Crohn disease can develop stricture and perforation in any part of the alimentary tract. However, duodenal Crohn disease is rarely observed and often difficult to treat. A 52-year-old man with Crohn disease presented with general fatigue, appetite loss, abdominal pain and diarrhea. Although several drugs (steroids, 5-ASA, immuno-modulator, anti-TNF-a antibody) were administrated considering recurrence of Crohn disease, his manifestations did not disappear and his nutritional condition was also worsened. Several examinations revealed his malnutrition due to bowel short-circuiting by duodenal fistula to terminal ileum adding to refractory Crohn disease. To remove the shortcircuiting, operation was performed. After removing the short-circuiting and closing the fistula, ileal partial resection was performed. Duodenum was diverted, then Billroth-II gastrojejunostomy and jejunostomy was carried out. After the operation, he achieved maintenance therapy using anti-TNF-a antibody. Consequently, we have succeeded in improvement of nutritional status and have not identified any recurrence of Crohn disease for postoperative eight months.
| 元の言語 | English |
|---|---|
| ページ（範囲） | 1157-1163 |
| ページ数 | 7 |
| ジャーナル | Japanese Journal of Gastroenterological Surgery |
| 巻 | 49 |
| 発行部数 | 11 |
| DOI | |
| 出版物ステータス | Published - 2016 |
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ASJC Scopus subject areas
- Surgery
- Gastroenterology
これを引用
Ileal duodenal fistula with malnutrition caused by crohn disease, improved by operation. / Matsui, Shimpei; Okabayashi, Koji; Hasegawa, Hirotoshi; Tsuruta, Masashi; Seishima, Ryo; Takahashi, Hidena; Yamada, Toru; Matsuda, Mutsuhito; Shimoda, Masayuki; Kitagawa, Yuukou.
：: Japanese Journal of Gastroenterological Surgery, 巻 49, 番号 11, 2016, p. 1157-1163.研究成果: Article
}
TY - JOUR
T1 - Ileal duodenal fistula with malnutrition caused by crohn disease, improved by operation
AU - Matsui, Shimpei
AU - Okabayashi, Koji
AU - Hasegawa, Hirotoshi
AU - Tsuruta, Masashi
AU - Seishima, Ryo
AU - Takahashi, Hidena
AU - Yamada, Toru
AU - Matsuda, Mutsuhito
AU - Shimoda, Masayuki
AU - Kitagawa, Yuukou
PY - 2016
Y1 - 2016
N2 - Crohn disease can develop stricture and perforation in any part of the alimentary tract. However, duodenal Crohn disease is rarely observed and often difficult to treat. A 52-year-old man with Crohn disease presented with general fatigue, appetite loss, abdominal pain and diarrhea. Although several drugs (steroids, 5-ASA, immuno-modulator, anti-TNF-a antibody) were administrated considering recurrence of Crohn disease, his manifestations did not disappear and his nutritional condition was also worsened. Several examinations revealed his malnutrition due to bowel short-circuiting by duodenal fistula to terminal ileum adding to refractory Crohn disease. To remove the shortcircuiting, operation was performed. After removing the short-circuiting and closing the fistula, ileal partial resection was performed. Duodenum was diverted, then Billroth-II gastrojejunostomy and jejunostomy was carried out. After the operation, he achieved maintenance therapy using anti-TNF-a antibody. Consequently, we have succeeded in improvement of nutritional status and have not identified any recurrence of Crohn disease for postoperative eight months.
AB - Crohn disease can develop stricture and perforation in any part of the alimentary tract. However, duodenal Crohn disease is rarely observed and often difficult to treat. A 52-year-old man with Crohn disease presented with general fatigue, appetite loss, abdominal pain and diarrhea. Although several drugs (steroids, 5-ASA, immuno-modulator, anti-TNF-a antibody) were administrated considering recurrence of Crohn disease, his manifestations did not disappear and his nutritional condition was also worsened. Several examinations revealed his malnutrition due to bowel short-circuiting by duodenal fistula to terminal ileum adding to refractory Crohn disease. To remove the shortcircuiting, operation was performed. After removing the short-circuiting and closing the fistula, ileal partial resection was performed. Duodenum was diverted, then Billroth-II gastrojejunostomy and jejunostomy was carried out. After the operation, he achieved maintenance therapy using anti-TNF-a antibody. Consequently, we have succeeded in improvement of nutritional status and have not identified any recurrence of Crohn disease for postoperative eight months.
KW - Crohn disease
KW - Ileal-duodenal fistula
KW - Malnutrition
UR - http://www.scopus.com/inward/record.url?scp=84997269752&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84997269752&partnerID=8YFLogxK
U2 - 10.5833/jjgs.2015.0042
DO - 10.5833/jjgs.2015.0042
M3 - Article
AN - SCOPUS:84997269752
VL - 49
SP - 1157
EP - 1163
JO - Japanese Journal of Gastroenterological Surgery
JF - Japanese Journal of Gastroenterological Surgery
SN - 0386-9768
IS - 11
ER -