Ileal duodenal fistula with malnutrition caused by crohn disease, improved by operation

Shimpei Matsui, Koji Okabayashi, Hirotoshi Hasegawa, Masashi Tsuruta, Ryo Seishima, Hidena Takahashi, Toru Yamada, Mutsuhito Matsuda, Masayuki Shimoda, Yuukou Kitagawa

研究成果: Article

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
49
発行部数11
DOI
出版物ステータスPublished - 2016

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Malnutrition
Crohn Disease
Fistula
Duodenal Diseases
Jejunostomy
Gastroenterostomy
Recurrence
Gastric Bypass
Antibodies
Appetite
Nutritional Status
Ileum
Duodenum
Abdominal Pain
Fatigue
Diarrhea
Pathologic Constriction
Steroids
Pharmaceutical Preparations

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

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AU - Matsui, Shimpei

AU - Okabayashi, Koji

AU - Hasegawa, Hirotoshi

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AU - Seishima, Ryo

AU - Takahashi, Hidena

AU - Yamada, Toru

AU - Matsuda, Mutsuhito

AU - Shimoda, Masayuki

AU - Kitagawa, Yuukou

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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.

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