CROHN’S DISEASE COMPLICATED BY ILEOSIGMOID FISTULA: ASSESSMENT AND MANAGEMENT UPDATE

The preoperative evaluation of Crohn’s-related ileosigmoid fistula (ISF) is complex with multiple diagnostic modalities available. Intraoperative management also complicated when deciding whether to repair the or resect involved sigmoid. How these choices impact outcomes not clear. We aim evaluate sigmoid resection versus conservative on postoperative complications treating ISF. Patients Crohn’s disease (CD) undergoing ileocolic in setting an ISF between January 1, 2007 and December 31, 2017 were identified. A retrospective chart review was conducted collect data workup, intra-operative technique, 30-day complications. Intra-abdominal sepsis defined as presence intra-abdominal abscess anastomotic leak from colon postoperatively. Univariate comparisons performed those primary anastomosis. 61 patients (62.3% female) a median age 37 years (range, 18-73)were included. Computed tomography enterography (CTE) magnetic resonance (MRE) each had sensitivity 100% 42% for colonoscopy. When accounting pre-operative endoscopy results, endoscopic sigmoidal mucosal CD more often underwent than normal mucosa only solitary fistulous opening (p<0.001). comparing vs there no difference occurrence septic (p=0.342) complication (p=0.239). In summary, our study shows that safe option. Appropriate patient assessment identification critical so strategies potential implications can be discussed patient. CTE MRE are choice diagnose ISF, while colonoscopy has role staging burden colon. These tests help guide surgical decision-making respect will allow whom innocent bystander undergo less extensive operation.Table 1Descriptive analysisView Large Image Figure ViewerDownload Hi-res image Download (PPT)