The Role Of Upfront Surgery in the Management of Ileal Crohn’s Disease

Abstract

Crohn's disease (CD) is a chronic inflammatory disorder characterized by transmural inflammation that can affect any part of the gastrointestinal tract. Among the various phenotypes of CD, involvement of the terminal ileum, known as ileal CD, poses unique challenges in management due to its potential for complications such as strictures, fistulas, and abscesses. While medical therapy remains a cornerstone in the management of CD, the role of surgery, particularly upfront surgical intervention (early resection), has garnered increasing attention in recent years.  The decision to pursue surgical intervention at the outset of disease management, rather than relying solely on medical therapy, is a subject of ongoing debate in the field. Upfront surgery (prior to advanced medical therapies) may offer benefits such as rapid resolution of symptoms, avoidance of long-term immunosuppressive therapy and prevention of disease progression. However, concerns regarding the postoperative morbidity and potential for recurrence associated with surgical intervention warrant careful consideration.