General Surgery III, University of Milan, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy.
Curr Drug Targets. 2010 Feb;11(2):242-8. doi: 10.2174/138945010790309984.
Crohn's disease (CD) is a chronic panenteric disease of unknown aethiology tending to progress, inspite medical or surgical treatment. Intestinal fibrosis is among the most common complications of CD, resulting in stricture formation in the small intestine and colon. About 75% of CD patients will undergo surgery at least once over the course of their disease and fibrotic strictures represents the main indication for surgery and the first cause of hospitalization and costs for CD patients. Clinical management of intestinal strictures depends on the type of stricture: inflammatory strictures are treated medically and are usually responsive to treatment, while fibrotic strictures require surgery. Clinical decisions regarding the right treatment choice for such conditions require proper knowledge on what to expect from the emerging drug strategies and surgical techniques. To achieve optimal results in patients management an approach combining the expertise of both gastroenterologist and colorectal surgeon is essential. This review aims at providing clinicians with an overview on fibrotic strictures in CD patients particular focus will be placed on the principal imaging modalities, and the medical, endoscopic and surgical treatment options with relative indications, according to the most recent evidence available.
克罗恩病（CD）是一种病因不明的慢性全肠疾病，尽管进行了医学或手术治疗，但仍有进展趋势。肠纤维化是 CD 最常见的并发症之一，可导致小肠和结肠形成狭窄。大约 75%的 CD 患者在疾病过程中至少会接受一次手术，而纤维化狭窄是手术的主要指征，也是 CD 患者住院和费用的首要原因。肠狭窄的临床管理取决于狭窄的类型：炎症性狭窄采用药物治疗，通常对治疗有反应，而纤维化狭窄则需要手术。对于此类疾病，正确治疗选择的临床决策需要对新兴药物策略和手术技术的预期有适当的了解。为了在患者管理中取得最佳效果，结合胃肠病学家和结直肠外科医生的专业知识至关重要。本文综述的目的是为临床医生提供 CD 患者纤维化狭窄的概述，特别关注主要的影像学方法，以及根据现有最新证据，针对相对适应证的药物、内镜和手术治疗选择。
