Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Table 1 Main indications for surgery in patients with Crohn’s disease

Indications	Treatment
Bowel obstruction	Conservative: Elimination of inflammation. On failure: Surgical resection of narrowed segment or endoscopic balloon dilatation
Intraabdominal abscess	Percutaneous drainage - administration of antibiotics. Surgery: Failure to improve septic symptoms, abscess rupture, multiple abscesses, enterectomy
Presence of fistulae	Simple fistulae: Pharmaceutical agents, enteral nutrition, biologic agents. Complex enteric fistulae: Surgery, treatment of sepsis, nutritional support
Perianal disease	Fistulae: Multidisciplinary approach, antibiotics, biological agents, surgery, stems cells. Abscess: Surgical drainage, antibiotics
Perforation	Emergency surgery
Massive bleeding	Conservative, endoscopic, invasive hemostasis. On failure: Emergency surgery
Malignancy	Absolute indication for surgery
Failure of conservative treatment	Drug intolerance, failure of biological agents, antibiotics, enteral nutrition, and total parenteral nutrition