In a patient excision rather than bypass is preferred for surgical treatment of small intestinal Crohn’s because:
**Core Concept**
The preferred surgical approach for small intestinal Crohn's disease depends on the extent and severity of the disease. In cases of small intestinal involvement, excisional surgery is often preferred over bypass surgery due to the risk of complications and the need for definitive management.
**Why the Correct Answer is Right**
Excisional surgery involves the removal of the diseased segment of the intestine, which is particularly beneficial in Crohn's disease. This approach helps to prevent complications such as bowel obstruction, fistula formation, and abscesses, which are common in patients with Crohn's disease. Additionally, excisional surgery allows for the removal of the diseased tissue, reducing the risk of recurrence. The resection of the diseased bowel segment also reduces the risk of complications associated with bypass surgery, such as bowel obstruction and malabsorption.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because bypass surgery involves creating a connection between two healthy segments of the intestine, which may not address the underlying disease process.
**Option B:** This option is incorrect because while resection and anastomosis is a surgical approach, it may not be the preferred method for small intestinal Crohn's disease due to the high risk of complications.
**Option C:** This option is incorrect because primary closure is not a viable option for resecting a diseased segment of the intestine in Crohn's disease, as the tissue may be too friable and prone to complications.
**Clinical Pearl / High-Yield Fact**
In patients with Crohn's disease, the risk of complications from surgical intervention is increased, and surgeons often prefer excisional surgery to prevent future complications.
**Correct Answer: C. Primary closure is not a viable option for resecting a diseased segment of the intestine in Crohn's disease, as the tissue may be too friable and prone to complications.