VM92 - Finney Stricturoplasty As a Solution For Two Adjacent Short Segment Small Bowel Strictures

Image or Table (Do Not add text here):

Purpose/Background: Finney stricturoplasty, introduced by Dr. John S. Finney in 1976, is a bowel-sparing surgical technique primarily used in the management of moderate length small bowel strictures, of particular importance in patients with Crohn’s disease. This approach is an invaluable bowel sparing option for the treatment of patients with strictures approximately 10-15 centimeters in length and in cases of multiple strictures. This technique widens the bowel lumen and preserves length by performing a side-to-side anastomosis through a longitudinal bowel incision and transversely closing it. The success rate ranges between 80-90% and the recurrence rate ranges between 20-30%.

Methods/Interventions: We present the case of a 42 year old male patient with a 7 year history of Crohn’s disease, who presented with intermittent nausea and vomiting accompanied by a 3 month history of 20 lb weight loss. Magnetic resonance enterography demonstrated multiple short segment strictures. Intraoperatively, the patient was found to have a total of 8 strictures all less than two centimeters. The majority of these were well spaced out and treated with Heineke-Mikulicz stricturoplasty with the exception of two immediately adjacent strictures. Though short, these two strictures were too close to be safely managed with this technique. We elected to open the bowel longitudinally across both strictures and perform a finney stricturoplasty.

Results/Outcomes: Intraoperatively the bowel was confirmed to be patent and the patient recovered postoperatively without complications.

Conclusion/Discussion: Finney stricturoplasty provides an effective bowel-sparing solution for addressing short segment strictures that are in close proximity, offering a safe and durable approach when conventional techniques, such as Heineke-Mikulicz stricturoplasty, are not suitable.