Duodenal Crohn'S Disease - Gastro-Jejunal Bypass Versus Duodenal-Jejunal Bypass - A Video Vignette

In this video S1, we describe two different approaches for the surgical treatment of duodenal Crohn´s disease (CD): the gastro-jejunal by-pass and the duodenal-jejunal by pass. The first patient, a 67-year-old male patient, had developed a stricture in the 4 part of the duodenum which was causing obstructive symptoms. A gastro-jejunal by-pass was performed but postoperatively the patient's symptoms persisted. A double-contrast EGD showed the anastomosis to be patent. At gastroscopy, there was severe oesophagitis due to biliary reflux secondary to the duodenal obstruction. At re-operation, a duodenal-jejunal by-pass was then performed with complete resolution of symptoms.