MANAGEMENT OF GASTROINTESTINAL-BLEEDING AFTER STRICTUREPLASTY FOR CROHNS-DISEASE

PURPOSE: To determine the incidence, clinical features, and optimal management of poststrictureplasty hemorrhage in Crohn's disease, METHODS: 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. RESULTS: 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. CONCLUSION: 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.