What is the general treatment for duodenal obstruction due to Crohn's disease after failed medical management?

The optimal treatment for duodenal obstruction due to Crohn's disease, particularly after medical management has failed, generally involves bypass procedures, with gastrojejunostomy being a common option. This procedure creates a connection between the stomach and the jejunum, circumventing the obstructed segment of the duodenum. It aims to alleviate the obstruction and restore bowel continuity while minimizing the risk of recurrence associated with Crohn's disease.

In cases of Crohn's, the affected bowel may be friable, and there is often a risk of postoperative complications such as strictures or infections. Gastrojejunostomy allows for the passage of food without removing any segments of the intestine that may still have disease activity, thereby preserving bowel length.

Other surgical options, such as strictureplasty or resections, may be utilized in different contexts but could carry higher risks of complications or recurrences in patients with extensive Crohn's disease. Resection with the Whipple procedure is more commonly indicated for malignancies or specific non-Crohn's related conditions rather than isolated duodenal obstruction. Duodenojejunostomy, while another bypass option, is less frequently the procedure of choice in this context, as it can be more complex and not