scholarly journals Fatal Moans and Bones in Crohn’s

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S22-S23
Author(s):  
J C Opara ◽  
N R Jackson
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Fatal Case ◽  
Disease Process ◽  
Oral Intake ◽  
Disease Status ◽  
Comfort Care ◽  
Autopsy Examination ◽  
Bone Fragments

Abstract Introduction/Objective Heterotopic mesenteric ossification (HMO) is a rare, reactive condition involving abnormal bone formation within the mesentery. While its etiology is uncertain, reports suggest two possible inciting events - either metaplasia from trauma and/or inflammation or dislodgment of bone fragments from other sites during abdominal surgery. With less than 50 reported cases, there is much unknown about this disease process. Herein, we present a rare, fatal case. Methods/Case Report A 43-year-old man with a history significant for Crohn’s disease status-post multiple abdominal surgeries and with resultant chronic abdominal pain was found unresponsive at home by family with an unknown downtime. He was taken to the local hospital where he was admitted to the Intensive Care Unit. Given a poor prognosis, family transitioned him to comfort care measures and he died shortly thereafter. Autopsy examination revealed a thin man with an ostomy and severe abdominal scarring. Internally, there were multiple aberrant bone fragments within the mesentery which neither perforated the bowel nor caused obstruction and which microscopically appeared to be mature and benign. Ancillary studies were significant severe dehydration. Follow-up conversation with his family revealed that due to debilitating abdominal pain, the decedent had significantly decreased his oral intake and had stopped taking medications to control his high output ostomy. Given the autopsy and investigative findings his death was certified as a natural death caused by dehydration due to complications of Crohn’s disease. Conclusion This is the first reported case of HMO occurring in inflammatory bowel disease. Awareness of this condition is important for clinicians as it can alter management of these patients. Early review and recognition from radiologists and pathologists can potentially improve the morbidity and mortality of this group.

scholarly journals An unusual case of chronic abdominal pain: an association between Celiac disease and Crohn’s disease

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Leen Jamel Doya ◽  
Maria Naamah ◽  
Noura Karkamaz ◽  
Narmin Hajo ◽  
Fareeda Wasfy Bijow ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Celiac Disease ◽  
Crohn's Disease ◽  
Histological Study ◽  
Gastrointestinal Diseases ◽  
Bowel Diseases ◽  
Oral Corticosteroids ◽  
History Of ◽  
High Caloric Diet

ABSTRACT Inflammatory bowel diseases (IBD) and Celiac disease (CeD) are immune-mediated gastrointestinal diseases with incompletely understood etiology. Both diseases show a multifactorial origin with a complex interplay between genetic, environmental factors, and some components of the commensal microbiota. The coexistence of celiac disease with Crohn’s disease is rarely reported in the literature. Here, we report a case of a 13-year-old Syrian male who presented with a history of abdominal pain, anorexia and pallor. CeD and Crohn’s disease was documented on gastrointestinal endoscopy and histological study. The patient was treated with a gluten-free, low fiber, high caloric diet, and a course of oral corticosteroids with an improvement in growth rate and abdominal pain.

P007 CROHN’S DISEASE: PREDICTORS OF HOSPITAL DISPOSITION AND COSTS USING DEMOGRAPHIC, CLINICAL, AND TREATMENT DATA

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S48-S48
Author(s):  
Hartman Brunt ◽  
Mason Adams ◽  
Michael Barker ◽  
Diana Hamer ◽  
J C Chapman
Keyword(s):  
Logistic Regression ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Hospital Admission ◽  
Categorical Variables ◽  
History Of ◽  
The Difference ◽  
The Impact ◽  
Total Charges

Abstract Purpose Crohn’s disease (CD) is an inflammatory bowel disease (IBD) caused by an abnormal immune response to intestinal microbes in a genetically susceptible host. The objective of this cohort analysis is to compare demographic characteristics, cost difference, and treatment modalities between patients who were discharged from the Emergency Department (ED) and those who were admitted to the hospital. Methods This study is a retrospective chart review of adult patients diagnosed with CD who were discharged from the ED and those who were admitted to the hospital between January 1, 2014 and January 1, 2017. We compared demographic and clinical characteristics as well as total charges incurred by these patients. A chi square test of independence and a Mann Whitney U-Test were used to compare categorical variables. Linear and logistic regression analyses were utilized to identify predictors of hospitalization and total charges. Results Of a total 195 patients, 97 were discharged from the ED and 98 were admitted to the hospital (Table 1). Patients who presented with fever, nausea/vomiting, or abdominal pain or who had a history of a fistula or stenosis were more likely to be hospitalized, as were patients who presented on steroids, 5-ASA compounds, or narcotics (Table 2). A logistic regression adjusted for these factors showed patients presenting with abdominal pain (OR=0.239, 95% CI 0.07 – 0.77) are less likely, while patients presenting with fever (OR=7.0, 95% CI 1.9 – 24.5) and history of stenosis (OR=17.8, 95% CI 5.7 – 55.9) are more likely to have a hospital admission. An increase in age and white blood cell count was associated with an increase in likelihood of admission (OR=1.04, 95% CI 1.01 – 1.07 and OR=1.2, 95% CI 1.1 – 1.4), while an increase in HGB was associated with a decrease in likelihood of admission (OR=0.682, 95% CI 0.55 – 0.83). Patients on 5-ASA compounds had the strongest association with hospital admission (OR=4.5, 95% CI 1.03 – 20.4). A linear regression analysis predicting total charges of hospitalization identified an increase of $37,500 (95% CI 6,600 – 68,489) for obese patients and of $29,000 (95% CI 20 – 57,000) for patients on narcotics prior to hospitalization. Notably, blacks were on average 6 years younger than whites (μ=36.2, st.d.=13.2 v μ=42.7, st.d.=18.2, p=0.031, respectively). No other differences in presentation or outcomes of CD were identified between these races. Conclusion This study describes the difference between CD patients who were admitted to the hospital compared to those who were discharged from the ED. The impact that 5-ASA compound, steroid, and narcotic use prior to presentation has on hospital admission and charges highlights the need for consistent outpatient care to manage the symptoms and disease progression in patients with CD in Baton Rouge. The difference in age at presentation between blacks and whites should also be considered in future research.

Increased Urinary Excretion of Iohexol after Enteral Administration in Patients with Ileal Crohn's Disease

1993 ◽  
Vol 34 (3) ◽  
pp. 237-241 ◽  
Author(s):  
L. Halme ◽  
J. Edgren ◽  
K. von Smitten ◽  
H. Linden
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Urinary Excretion ◽  
High Performance ◽  
Cell Damage ◽  
Oral Intake ◽  
Reversed Phase ◽  
Water Soluble ◽  
Mucosal Cell

Iohexol is a water-soluble contrast medium that is partly absorbed/permeated through mucosa of the small bowel and excreted unchanged in the urine. Iohexol was administered orally to 12 patients with Crohn's disease of the ileum and to 10 healthy controls to measure its excretion in the urine. The location and activity of Crohn's disease were determined by barium double-contrast radiography in all patients and by ileoscopy and biopsy in 9 patients. Iohexol concentrations in serum and 24-hour urine were measured using reversed phase high-performance liquid chromatography. Urinary excretion of iohexol was significantly greater in patients with active Crohn's disease than in controls. We suggest this method as a new way of measuring Crohn's disease activity and mucosal damage in the small bowel. Bowel inflammation and mucosal cell damage are strongly indicated if the iohexol excreted in the urine is over 1% of the oral intake.

Colonoscopy in Childhood

PEDIATRICS ◽  
1984 ◽  
Vol 73 (5) ◽  
pp. 594-599
Author(s):  
Eric Hassall ◽  
Glen N. Barclay ◽  
Marvin E. Ament
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Barium Enema ◽  
Colonic Disease ◽  
Radiographic Diagnosis ◽  
Inflammatory Bowel ◽  
Fiberoptic Colonoscopy

A review was made of 139 fiberoptic colonoscopies performed between 1975 and 1982 on 113 patients aged 1 month to 20 years. General anesthesia was used in four procedures. All others were done under sedation with meperidine (mean dose 2.9 mg/kg) and diazepam (mean dose 0.5 mg/kg). Indications were rectal bleeding in 52 patients; assessment and surveillance of known inflammatory bowel disease in 33 patients; and diagnostic evaluation of abdominal pain, diarrhea, and/or fever in 28 patients. The cecum was reached in 84% of diagnostic examinations. Comparison of findings on colonoscopy with barium enema in 75 patients showed agreement in 46, colonoscopic superiority in 25, and barium enema superiority in four. Bleeding sufficient to cause anemia was seen in 10/26 patients with polyps. Five minor complications and no major complications occurred. Flexible fiberoptic colonoscopy and polypectomy may be done usefully in childhood by physicians well versed and experienced with these procedures. Colonoscopy and biopsy changed the radiographic diagnosis from ulcerative colitis to Crohn's disease in several cases and indicated greater extent of colonic disease in several cases of ulcerative colitis and Crohn's disease. Colonoscopy is usually the most sensitive and accurate diagnostic tool for the evaluation of colonic disease, but barium enema and colonoscopy are complementary tests and barium enema should usually precede colonoscopy, with certain exceptions.

Predictors of Abdominal Pain in Depressed Pediatric Crohn's Disease Patients

2011 ◽  
Vol 140 (5) ◽  
pp. S-91
Author(s):  
Arvind I. Srinath ◽  
Alka Goyal ◽  
David J. Keljo ◽  
David G. Binion ◽  
Eva Szigethy
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease

Small Bowel Adenocarcinoma Complicating Crohn's Disease

1992 ◽  
Vol 37 (2) ◽  
pp. 54-55 ◽  
Author(s):  
H.E. Ellamushi ◽  
I.S. Smith
Keyword(s):  
Small Intestine ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Small Bowel Obstruction ◽  
Medical Therapy ◽  
Acute Abdominal Pain ◽  
Fistula Formation ◽  
Small Bowel Adenocarcinoma

Crohn's disease of the small intestine is usually managed by medical therapy with surgery being reserved for obstruction or fistula formation. A patient is described who developed small bowel obstruction due to an adenocarcinoma of the ileum after over twenty years of medical therapy for Crohn's disease, originally diagnosed at a laparotomy for acute abdominal pain. The possibility of malignancy in such long-standing disease should be considered.

scholarly journals Low Back Pain After Sudden Onset of Abdominal Pain in a Patient with Crohn's Disease

2016 ◽  
Vol 129 (4) ◽  
pp. e9-e10
Author(s):  
Kiyoshi Shikino ◽  
Shingo Suzuki ◽  
Yuta Hirose ◽  
Yoshiyuki Ohira ◽  
Masatomi Ikusaka
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Crohn's Disease ◽  
Sudden Onset ◽  
Low Back

scholarly journals T-Cell Lymphoma Misdiagnosed as Crohn’s Disease: Case Report

2020 ◽  
Vol 74 (2) ◽  
pp. 144-149
Author(s):  
Zane Straume ◽  
Justīne Māliņa ◽  
Anna Proskurina ◽  
Jurijs Nazarovs ◽  
Aleksejs Derovs ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Abdominal Pain ◽  
T Cell ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Inflammatory Bowel ◽  
Small And Large Intestine

AbstractFor many years, there has been a concern that inflammatory bowel disease carries an increased lymphoma risk. At the same time, patients with intestinal lymphomas are occasionally misdiag-nosed as having Crohn’s disease. We report a case of T-cell lymphoma of the bowel misdiag-nosed as Crohn’s disease, which illustrates the diagnostic challenges posed by peripheral extranodal lymphomas. A 68-year old female presented with clinical symptoms (diarrhoea, abdominal pain, poor appetite and significant weight loss), and colonoscopic and initial histological findings that were similar to inflammatory bowel disease. She was diagnosed with Crohn’s disease and received treatment with sulfasalazine with subsequent improvement of symptoms. Eight months after the initial diagnosis the patient experienced sudden abdominal pain. Laparotomy revealed necrosis in the small and large intestine and ileostomy was performed. On day 10 of a complicated postoperative period the patient died. Post-mortem histopathological examination of small and large intestine revealed highly malignant peripheral T-cell lymphoma, not otherwise specified. Differentiation of intestinal T-cell lymphoma from Crohn’s disease continues to be a challenge, because clinical, colonoscopic, radiological and histopathological findings can mimic Crohn’s disease. Careful multi-disciplinary assessment and knowledge of this rare disorder is crucial for timely diagnosis.

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