[Crohn's disease of the small intestine: place of surgery in 1992].

Crohn's disease (CD) is a chronic pan-enteric inflammatory disease of unknown etiology. Although treatment of CD of small intestine is at present principally medical, in the majority of cases surgical intervention is unavoidable, essentially to treat complications such as occlusion, intra- and/or extra-abdominal abscess, certain fistulae, intraperitoneal perforation, profuse hemorrhage and neoplastic degeneration. Surgery may also be indicated during acute episodes of corticotherapy resistant CD, and as a valid alternative to only partially effective long term corticoid treatment of an active chronic disease. Experience has shown that surgery should be as conservative as possible, "stricturoplasty" being the treatment of choice for stenotic lesions. Postoperative follow-up conditions have still to be formulated because of the marked variations in manifestations of recurrence of the disease.