0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Diagnosis and Treatment of Duodenoenteric Fistulas Complicating Crohn's Disease

Kenneth K. W. Lee, MD; Wolfgang H. Schraut, MD
Arch Surg. 1989;124(6):712-715. doi:10.1001/archsurg.1989.01410060082017.
Text Size: A A A
Published online

• A duodenoenteric fistula is an unusual complication of Crohn's disease that requires surgical intervention and may present a difficult management problem. Eleven patients with this condition were treated with an ileocolectomy with primary anastomosis and closure of the duodenal defect after takedown of the fistula. In all patients, the duodenal tissues were free of pathologic evidence of Crohn's disease. The fistula was found to result from Crohn's disease limited to the ileocolonic segment or from anastomotic complications in some patients who had previously undergone ileocolonic resections. Satisfactory healing at the ileocolonic anastomosis and at the duodenal closure site occurred in ten patients; breakdown of the duodenal closure leading to sepsis and death occurred in one patient with an unusually large defect in the first portion of the duodenum. In most instances, these fistulas can be treated safely and adequately by resection of the diseased intestinal segment and simple direct duodenal closure. However, safe management of large duodenal defects may require the use of other methods, such as a serosal patch or creation of a duodenojejunostomy.

(Arch Surg 1989;124:712-715)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();