Patient records
Name: David
Age: 35
Nationality: British
Diagnosis: Crohn's disease (ileocolic type, stricture type), recurrent small bowel obstruction
Treatment Hospital: Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
Crohn's disease, known as the "green cancer," is incurable and recurrent, leading to serious complications such as intestinal stenosis, perforation, and fistulas. David's story tells how he found a precise balance between "over-operation" and "recurrent obstruction" in China.
1. An intestine that has been repeatedly "blocked"
David, a software engineer in London, was diagnosed with Crohn's disease 10 years ago. Despite treatment with biologics (infliximab), his condition has been recurrent, primarily affecting the ileocecal junction and terminal ileum. For the past two years, he has experienced recurrent intestinal obstruction, each episode accompanied by severe abdominal pain, bloating, and vomiting, requiring emergency room admission, fasting, and gastrointestinal decompression. A CT scan revealed fibrotic stenosis in his terminal ileum, a result of long-term chronic inflammation leading to intestinal wall thickening and fibrosis, which is irreversible with medication.
A gastrointestinal surgeon in London recommended surgery to remove the narrowed section of his intestine. But David hesitated because he knew that Crohn's disease could affect the entire digestive tract, and that surgical removal would only be a temporary solution. Moreover, each removal would result in the loss of a portion of the intestine, and multiple surgeries could lead to short bowel syndrome, requiring lifelong parenteral nutrition.
2. Our Value: Finding the precise balance between "surgery" and "obstruction" in stenosis repair surgery.
David learned through the international Crohn's disease support community that a surgical procedure called "stenosis plasty" is highly recommended in the surgical treatment of Crohn's disease in China. This surgery does not remove the narrowed segment of the intestine, but rather, like "cutting open a ring that is too tight," it longitudinally cuts open the narrowed intestinal segment and sutures it transversely, thereby widening the intestinal lumen, relieving the obstruction, and preserving the intestine to the greatest extent possible.
After reviewing his CT scan of the small bowel and colonoscopy reports, we confirmed that his stenosis was short (<10cm) and solitary, making him very suitable for stenosis repair surgery. Based on his condition and needs, we paved a reassuring path for him , from "remote consultation" to "long-term follow-up."
First, Precise matching and treatment plan planning. We matched him with Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, a center in China with extensive experience in the surgical treatment of inflammatory bowel disease (IBD). During the remote consultation, the experts planned a comprehensive treatment plan for him that included "precise surgery + postoperative medication optimization": first, ileocecal resection + terminal ileal stricture repair; postoperatively, based on the pathology and disease activity, the type and dosage of biological agents would be optimized to prevent recurrence.
Second, Full-time care and nutritional support. After David arrived in China, our English-speaking coordinator accompanied him throughout his surgery. Post-surgery, we connected him with a clinical nutritionist at the hospital to develop a specific enteral nutrition plan for Crohn's disease, helping him through the post-operative recovery period and improving his nutritional status.
Third, Post-operative care and follow-up. We established a "Crohn's Disease Post-operative Remote Follow-up File" for him, with the core task of monitoring disease activity and preventing recurrence. We collect his Crohn's Disease Activity Index (CDAI) score, fecal calprotectin, erythrocyte sedimentation rate (ESR), CRP, and other inflammatory markers monthly via remote follow-up. Every six months, we coordinate a colonoscopy in London and share the results with our Chinese specialists. Our goal is to achieve a longer remission period and avoid further surgery through meticulous post-operative management .
3. Therapeutic Effects and Insights
One year after the surgery, David's bowel obstruction did not recur, he gained 10 kilograms, and his quality of life improved significantly. In an email to us, he wrote: "Thank you for helping me find a precise balance between 'over-operation' and 'recurrent obstruction.' You showed me that surgery for Crohn's disease is not just about 'cutting' or 'not cutting,' but also about this more refined and humane approach."