scholarly journals Iliopsoas Abscess as the First Clinical Manifestation of Crohn’s Disease - A Rare Case Report and Literature Review

2019 ◽  
pp. 1-3
Author(s):  
Cristiano Alpendre ◽  
Abdul Waheed ◽  
Cristiano Alpendre ◽  
Kai Huang ◽  
Nikita Sijapati ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Rare Complication ◽  
Right Hemicolectomy ◽  
Rare Presentation ◽  
Ct Guided ◽  
Iliopsoas Abscess ◽  
Rare Case Report ◽  
Duodenocolic Fistula ◽  
The Right

Objective: Iliopsoas abscess is a rare complication of fistulizing Crohn’s disease, which is difficult to diagnose and manage. We report this case to alert clinicians to the diagnosis and management of this unusual association. Case presentation: A 31-year-old male who presented with right groin pain, and hip pain due to an iliopsoas abscess. He was found to have iliopsoas fistula and underlying Crohn’s disease. The right iliopsoas abscess was managed with CT guided percutaneous drainage and pigtail catheter placement and intravenous antibiotics. The patient was started on mesalamine and prednisone. A month later, the patient became symptomatic again and a duodenocolic fistula was found. A laparoscopic extended right hemicolectomy with both fistulas takes-down, end ileostomy and mucus fistula were performed. Pathology revealed chronic active Crohn’s ileocolitis. His ileostomy was reversed three months later. The patient recovered uneventfully and was doing well after six-month follow-up. Conclusions: Iliopsoas abscess can be a rare presentation of Crohn’s disease. Evaluation with CT imaging, and initial management with drainage and antibiotics are recommended. Surgical intervention should be considered early for impending arthritis.

scholarly journals RARE COMPLICATION OF CROHN’S DISEASE WITH LOCALIZATION IN THE INFLAMMATORY INTESTINE IN THE F0ORM OF THE SPREAD OF INFLAMMATORY OF THE PROCESS ON THE ANTERIOR ABDOMINAL WALL WITH FORMATION ABSCESS AND ITS DISCLOSURE IN THE NAVEL

2021 ◽  
pp. 66-70
Author(s):  
O. A. Povch ◽  
S. O. Rebenkov ◽  
A. V. Kovalchuk ◽  
A. B. Bilyakov-Belskiy ◽  
V. M. Sidorenko ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Rare Complication ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Right Hemicolectomy ◽  
Complicated Course

The purpose of the study. Show a rare variant of the clinical course of complications of Crohn’s disease (СD). To analyze the anamnestic data, symptoms, clinical manifestations, preoperative diagnosis, features of surgery, postoperative period and the results of histological examination in a patient with CD who had complications in the form of transition of inflammation from the ileal wall to the anterior abdominal wall with abscess formation, opening it in the navel and the formation of a fistula. Material and methods. An analysis of the case of a complicated course of CD, manifested by the transition of inflammation from the ileum to the anterior abdominal wall, the formation of an abscess, its breakthrough into the navel and the formation of a fistula in the umbilical region. This complication was detected only after urgent computed tomography of the abdominal cavity and small pelvis (CTACSP). Results. The patient, despite the history of complaints, performed appendectomy, in which the removed appendix did not fully correspond to the clinical manifestations and data of CTACSP, in which CD was suspected, did not complete the examination, was not consulted by gastroenterologists and proctologists. He was urgently hospitalized with a clinic similar to acute purulent omphalitis. Only careful collection of the anamnesis and performance of urgent CTACSP allowed to suspect existence at the patient of the complicated course of CD. This allowed us to predict the course of surgery, perform a right hemicolectomy with excision of the altered tissues of the anterior abdominal wall and suturing the wound in the form of a laparostomy. The patient’s condition improved, he was discharged from the hospital. Conclusions. Patients with suspected CD should be monitored and treated by gastroenterologists and proctologists. Careful collection of anamnesis in patients of this group and the implementation of emergency CTACSP allowed to establish a correct diagnosis in the preoperative period.

scholarly journals Appendiceal Crohn’s disease: a rare differential of right iliac fossa pain

2020 ◽  
Vol 13 (2) ◽  
pp. e232549
Author(s):  
Adam James Crellin ◽  
Omar Musbahi ◽  
Natasha Onwu ◽  
Sandeep Singh
Keyword(s):  
Crohn’S Disease ◽  
Abdominal Pain ◽  
Crohn's Disease ◽  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Emergency Unit ◽  
Good Recovery ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right

A 30-year-old man with a history of severe right iliac fossa pain was referred to the surgical emergency unit. His symptoms began 3 days prior as mild, non-specific abdominal pain which progressively localised to the right iliac fossa and worsened in severity. Investigations were suggestive of acute appendicitis, and therefore a laparoscopic appendicectomy was planned. Laparoscopy revealed a thickened, necrotic appendix with a mass at the base of the appendix, in keeping with the appearance of an appendiceal malignancy. Subsequently a right hemicolectomy was performed. Histology revealed active chronic inflammation and granulomas highly suggestive of appendiceal Crohn’s disease. Since, the patient has made a good recovery and presently shows no further signs of Crohn’s disease. This case is demonstrative of one of many rare findings on histological examination of the appendix. It emphasises the need for a wide differential when investigating right iliac fossa pain.

scholarly journals Difficult cases of differential diagnosis of acute appendicitis

2021 ◽  
Vol 8 (3) ◽  
pp. 133-139
Author(s):  
L. A. Otdelnov ◽  
A. M. Mastukova
Keyword(s):  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Acute Appendicitis ◽  
Young Patient ◽  
Right Hemicolectomy ◽  
Greater Omentum ◽  
Intestinal Fistula ◽  
First Case ◽  
The Right

Despite the results of technological progress in medicine, which has made high-resolution methods of medical imaging available, the problem of differential diagnosis of acute appendicitis does not lose its’ relevance. This can be explained by the fact that the symptoms of acute appendicitis are variable, non-specific, and can mimic other diseases with similar symptoms.Three cases of rare diseases of the gastrointestinal tract that simulates acute appendicitis were presented. Those are primary torsion of the greater omentum with necrosis, caecum cancer with lengthy necrosis in a young patient and Crohn's disease that simulates appendicular infiltrate. All patients underwent surgery. Signs of acute appendicitis were indications for surgery. Laparoscopic resection of greater omentum was performed in the first case. In the second case caecum necrosis with peritonitis was revealed by laparoscopy. Conversion laparoscopy to laparotomy was performed. Caecum necrosis with caecum wall perforation and necrosis of terminal part of the ileum was diagnosed. right hemicolectomy with ileo-transverso anastomosis was carried out. Complicated case of Crohn’s disease was suspected. Nevertheless, the diagnosis of colorectal cancer is established by pathomorphology only. This case is interesting because of rare complication of colon cancer – the caecum and the ileum wall necrosis that was manifestation of the disease. In the third case of Crohn’s disease in a young patient the diagnosis of appendicular infiltrate and surgical policy were wrong. At the first laparotomy by McBurney was performed. A dense infiltrate was found in the right iliac fossa. The intervention was finished by local abdominal package. In the early postoperative period an intestinal fistula was formed. The patient underwent relaparotomy and right hemicolectomy with ileo-transversal anastomosis was carried out. Despite the diagnosis of Crohn's disease was questionable patomorphology and was established after half a year only by colonoscopy. The presented cases illustrate the complexity of acute appendicitis and the importance of modern approaches to diagnosis: irreplaceability of laparoscopy and the feasibility of using diagnostic scales. When the right diagnosis is not clear the intervention might be late for using methods of instrumental diagnostics.

Quadriplegia, a Rare Complication of Pediatric Crohn's Disease, Successfully Treated with Endovascular Thromboembolectomy

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 408A-408A
Author(s):  
Riana Riffle ◽  
Amro Abdulsattar ◽  
Sean Meagher ◽  
Girish Deshpande
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Rare Complication

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

Left iliopsoas abscess complicating Crohn's disease: case report and review of literature

Chirurgia ◽  
2017 ◽  
Vol 30 (4) ◽  
Author(s):  
Donatella Pisaniello ◽  
Nicola Della Valle ◽  
Nicola Crucinio ◽  
Anna Carretta ◽  
Giovanni Di Gioia ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Review Of Literature ◽  
Iliopsoas Abscess ◽  
Disease Case

CMV pneumonitis in a patient with Crohn’s disease taking azathioprine

2021 ◽  
Vol 14 (4) ◽  
pp. e241256
Author(s):  
Timothy Zef Hawthorne ◽  
Rachel Shellien ◽  
Lucy Chambers ◽  
Graham Devereux
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Low Dose ◽  
Antiviral Treatment ◽  
Cmv Infection ◽  
Rare Presentation ◽  
Intravenous Ganciclovir ◽  
Increased Risk ◽  
Oral Valganciclovir

This case report discusses the rare presentation of cytomegalovirus (CMV) pneumonitis in a young patient with moderately severe Crohn’s disease managed with low dose azathioprine. CMV pneumonitis was initially suspected on CT chest images and confirmed by PCR for CMV. She was treated with intravenous ganciclovir and later stepped down to oral valganciclovir. Although this patient had a prolonged and complicated hospital admission, a good clinical outcome was achieved. CMV infection was raised as an early differential and antiviral treatment was started without delay. This case study, therefore, makes the case for increased awareness of the possibility of, and recognition of CMV pneumonitis among healthcare professionals as a way of preventing significant morbidity and mortality. It also raises awareness of checking for slow metabolisers of azathioprine before initiation to look for individuals who may be at increased risk of azathioprine’s adverse effects.

scholarly journals Pulmonary Crohn's Disease in Down Syndrome: A Link or Linkage Problem

2016 ◽  
Vol 10 (2) ◽  
pp. 206-211
Author(s):  
Danyal Thaver ◽  
Mirza Beg
Keyword(s):  
Down Syndrome ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pediatric Population ◽  
Pulmonary Nodules ◽  
Pulmonary Involvement ◽  
Lung Nodules ◽  
Inflammatory Disorder ◽  
Ct Guided ◽  
History Of

Crohn’s disease (CD) is an autoimmune inflammatory disorder that primarily affects the gastrointestinal tract. It may have pulmonary involvement, which has been rarely reported in pediatric patients. Down syndrome (DS) has been associated with increased frequency of autoimmune diseases. However, associations between CD and DS have been rarely reported. We present the case of a 5-year-old girl with known DS and a history of chronic intermittent abdominal pain who presented with persistent pneumonia. Her workup included a chest computed tomography (CT) scan that showed multiple noncalcified pulmonary nodules. An extensive infectious workup was done that was negative. CT-guided needle biopsy of the lung nodules showed necrotizing granulomas. This raised concern for primary CD with extraintestinal pulmonary manifestation. An esophagogastroduodenoscopy and colonoscopy were performed, and colon biopsies showed scattered epithelioid granulomas. Based on this information, there was consensus that her lung nodules were secondary to CD. She was started on standard therapy for CD, and her abdominal and respiratory symptoms gradually improved. However, she continues to have mild residual lung calcification and fibrosis. To our knowledge, this is the first reported case of pulmonary CD in a child with DS. The natural history of pulmonary CD in the pediatric population is not very well studied. Furthermore, since DS has been well known to be associated with increased frequency of malignancies and autoimmune conditions due to immune dysregulation, it is difficult to predict the severity and possible complications in this patient.

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