Extended strictureplasty for multiple short skipped strictures of Crohn's disease.

Abstract

We will describe a new procedure for treatment of multiple short strictures involving a short segment of Crohn's disease. This procedure involves the following: 1) stay sutures at the mid portion of the two strictures; 2) an antimesenteric longitudinal enterotomy of 12 cm or more; 3) two or three interrupted transmural sutures in the four lateral portions of the two stenoses; 4) a transverse running suture, according to Heineke-Mikulicz-type strictureplasty; and 5) interrupted seromuscular sutures. We performed four such "double Heineke-Mikulicz"-type strictureplasties in three patients with Crohn's disease without postoperative complications. This type of double Heineke-Mikulicz-type strictureplasty is suitable for multiple short skipped strictures of Crohn's disease in selected patients.