Patient selection: bowel resection for Crohn's disease
Parameters:
(1) duodenum (from pylorus to duodenojejunal flexure)
(2) jejunoileum (set to a length of 400 cm)
(3) ileocolonic junction (from 5 cm proximal to the ileocecal valve)
(4) colon (divided into right, transverse and left segments)
(5) rectal (distal to rectosigmoid junction, terminating at anus)
|
Segment Resected
|
Points
|
|
duodenum
|
(percent resected) * 8
|
|
jejunoileum
|
MIN(50,(length resected)*0.125)
|
|
ileocolonic junction
|
10
|
|
right colon
|
(percent resected) * 7
|
|
transverse colon
|
(percent resected) * 7
|
|
left colon
|
(percent resected) * 7
|
|
rectum
|
(percent resected) * 11
|
where:
• The jejunoileum is set at 400 cm and assigned 50 points, so each cm is 50/400 or 0.125.
total postoperative handicap index =
= SUM(points for resected bowel)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the score the greater the impairment of bowel function.
• Indices from previous surgeries can be added for a running total.
percent fecal fat =
= 89.2 - (20.6 * LN(75 - (index)))
