PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the most common indication for surgery in patients with Crohn's disease?

1. Cancer

2. Stricture or obstruction

3. Fistula formation

4. Appendicitis

The correct answer is: Stricture or obstruction

The most common indication for surgery in patients with Crohn's disease is stricture or obstruction. Crohn's disease is a chronic inflammatory bowel disease that can cause various complications, one of the most prevalent being strictures, which are narrowing of the intestinal tract due to inflammation and scarring. Over time, these strictures can lead to bowel obstruction, where the normal passage of digestive contents is impeded. When conservative treatments, such as medication and dietary changes, fail to relieve the symptoms or if the patient presents with significant obstruction leading to complications like bowel distension or perforation, surgical intervention becomes necessary. Surgery may involve resection of the affected segment of the bowel or bowel bypass procedures, depending on the severity and location of the stricture. Other potential indications for surgery, such as fistula formation, can occur in Crohn's patients but are typically less common as initial surgical requirements compared to strictures. Cancer is also a concern in long-standing Crohn's disease, but it is not as immediate a reason for surgical intervention as bowel obstructions caused by strictures. Appendicitis can occur in patients with Crohn's, particularly those with ileal involvement, but is not exclusive to Crohn's disease and does not represent the primary reason