Management of gastrointestinal bleeding after strictureplasty for Crohn's disease.

Abstract

To determine the incidence, clinical features, and optimal management of poststrictureplasty hemorrhage in Crohn's disease. Retrospective analysis of 139 patients with Crohn's disease seen at the Cleveland Clinic who underwent a total of 523 strictureplasties between June 1984 and June 1992. Poststrictureplasty hemorrhage occurred in 13 patients (9.3 percent). Average drop in hemoglobin and hematocrit in these patients was 5.8 g/dl and 0.174, respectively. All patients were managed nonoperatively. Mean follow-up was 29.6 (range, 7-62) months. Strictureplasty in Crohn's disease is a safe procedure in selected patients. Poststrictureplasty hemorrhage is uncommon; however it can be managed nonoperatively in most cases. An algorithm for management of such patients is presented.