In a patient excision rather than bypass is preferred for surgical treatment of small intestinal Crohn's because:
Excision is safer.
Bypass does not relieve symptoms.
Excision cures the patient of Crohn's disease but bypass does not.
The risk of small intestine cancer is reduced.
- Bypass of segments of small bowel affected with Crohn's disease is a safe operation with few complications, and one that usually relieves symptoms promptly. - It leaves diseased bowel behind, however, which can flare in the future and can develop carcinoma. - Excision, though it does not cure the Crohn's disease, removes the areas of severe involvement and so eliminates the risk of developing cancers in these segments - Indications of Surgery in Crohn's disease: Indications in Small intestine Stricture & Obstruction unresponsive to Medical therapy Massive haemorrhage Refractory fistula Abscess Indications in Colon & Rectum Intractable disease Fulminant disease Perianal disease unresponsive to medical management Refractory fistula Colonic obstruction Cancer prophylaxis Colonic Dysplasia or Cancer
Inflammatory bowel disease