Proper Experience of Complex Treatment of a Patient with Complicated Crohn's Disease: Application of Vacuum Duodenal Obturation in Closing High Small Intestinal Fistulas

Abstract

The paper highlights a clinical case of a newly diagnosed Crohn's disease with extended involvement of the small intestine in a 63-year-old patient. The course of the disease was complicated by multiple acute ulcers with perforations and peritonitis; due to this the patient was repeatedly exposed to surgical interventions. As a result of a long-term inflammatory process in the abdominal cavity, the patient developed small intestinal fistulas on the remaining short small intestine. Surgical treatment was combined with a comprehensive conservative treatment of Crohn's disease, parenteral nutrition via an intravenous port, antibiotic therapy, infusion therapy, etc. The authors first applied an intraluminal duodenal endosponge with programmable vacuum aspiration. Complete duodenal obturation was successfully achieved. The use of this design has played a crucial part in the complex treatment of small intestinal fistulas in the presented patient.