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Multidisciplinary approach in the treatment of acute intestinal obstruction in Crohn’s disease

https://doi.org/10.24884/1607-4181-2025-32-3-122-127

Abstract

Introduction. The authors of the article address one of the most pressing issues in modern gastroenterology and coloproctology – the choice of an optimal approach to treating acute complications of Crohn’s disease (CD), such as intestinal obstruction. This work is notable for its interdisciplinary nature and its focus on the specifics of diagnosis and treatment during an acute crisis, where timing and the accuracy of decision-making play a crucial role. The researchers rightly point out that most patients with CD experience recurrent exacerbations and complications such as intestinal obstruction, which require a specialized treatment approach. Standard surgical protocols used for similar conditions in other patients may be ineffective or overly aggressive, leading to undesirable outcomes. The need for a differentiated approach underscores the particular relevance of the topic.

The objective of the article was to demonstrate the feasibility and importance of an interdisciplinary approach in managing acute complications of CD. The authors aimed to present a clinical case that illustrated the benefits of collaboration between gastroenterologists, colorectal surgeons, and general surgeons in deciding on a treatment strategy. The objective was clearly defined and achievable, allowing the article to effectively showcase the advantages of a multidisciplinary approach.

Methods and materials. The central element of the article is a clinical case of a patient with acute intestinal obstruction during a CD exacerbation. An emergency surgery was initially recommended, but thanks to a prompt interdisciplinary consultation, a conservative treatment plan was chosen, which helped avoid unnecessary surgical intervention. This approach strengthens the evidence base of the article, serving as a vivid illustration of the importance of interdisciplinary collaboration.

Results. One of the major strengths of the article is the detailed description of the treatment course in this particular case. The specific steps taken by the medical team led to a successful resolution without surgery, avoiding serious complications and adverse outcomes for the patient. The results support the authors’ central thesis: managing complications of CD requires tailored approaches distinct from standard protocols used for other conditions.

Conclusion. The authors’ key conclusion is the necessity of conducting interdisciplinary consultations when diagnosing and choosing a treatment strategy for patients with acute manifestations of CD. Their conclusion is supported by a specific clinical case showing that well-coordinated collaboration among specialists from different fields can help avoid unwarranted surgical interventions and minimize the risk of complications.

About the Authors

V. P. Morozov
Pavlov University
Russian Federation

Morozov Victor P., Dr. of Sci. (Med.), Professor, Head of the Department of General Surgery with Clinic

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



A. Kamanin
Pavlov University
Russian Federation

Kamanin Alexey A., Cand. of Sci. (Med.), Associate Professor of the Department of General Surgery with Clinic

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



V. V. Kostyukov
Pavlov University
Russian Federation

Kostyukov Vladislav V., Clinical Resident, Department of General Surgery with Clinic

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



A. U. Korolrov
Pavlov University
Russian Federation

Korolrov Andrey U., Dr. of Sci. (Med.), Professor, Head of the Department of Hospital Surgery № 2, Head of the Department of General and Emergency Surgery, Research Institute of Surgery and Emergency Medicine, Deputy Chief Physician of the Clinic for Surgery

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



O. B. Shchukina
Pavlov University
Russian Federation

Shchukina Oksana B., Dr. of Sci. (Med.), Professor of the Department of General Medical Practice (Family Medicine), Head of the Office of Inflammatory Bowel Diseases of the Clinic with a Clinical Diagnostic Center

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



D. V. Kulikov
Pavlov University
Russian Federation

Kulikov Dmitry V., Cand. of Sci. (Med.), Surgeon, Surgical Department № 3

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



D. G. Nomokonov
Pavlov University
Russian Federation

Nomokonov Dmitry G., Senior Laboratory Assistant of the Department of General Surgery with  Clinic

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



R. V. Cheminava
Pavlov University
Russian Federation

Cheminava Revaz V., Dr. of Sci. (Med.), Professor of the Department of General Surgery with Cinic

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



S. F. Bagnenko
Pavlov University
Russian Federation

Bagnenko Sergey F., Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Rector

6-8, L’va Tolstogo str., Saint Petersburg, 197022


Competing Interests:

Authors declare no conflict of interest.



References

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For citations:


Morozov V.P., Kamanin A., Kostyukov V.V., Korolrov A.U., Shchukina O.B., Kulikov D.V., Nomokonov D.G., Cheminava R.V., Bagnenko S.F. Multidisciplinary approach in the treatment of acute intestinal obstruction in Crohn’s disease. The Scientific Notes of the Pavlov University. 2025;32(3):122-127. (In Russ.) https://doi.org/10.24884/1607-4181-2025-32-3-122-127

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ISSN 1607-4181 (Print)
ISSN 2541-8807 (Online)