scholarly journals Ultrasound-Guided Percutaneous Drainage of Abdominal Abscess in a Patient With Crohn's Disease: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Radmila V. Karpova ◽  
Ksenia S. Russkova ◽  
Roman N. Komarov ◽  
Arina A. Petrova
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Fibrin Glue ◽  
Intravenous Administration ◽  
Immune Status ◽  
Diagnostic Algorithm ◽  
Abscess Cavity ◽  
Intestinal Fistula ◽  
Lower Quadrant ◽  
The Right

Introduction: The autoimmune process in Crohn's disease exacerbates destructive changes in the intestinal wall and leads to complications such as bleeding (21. 9%), strictures (21.6%), and abscesses (19.7%).Case Presentation: The case of a 32-year-old male patient with an 8-year history of Crohn's disease is presented. He was admitted for emergency indications with severe pain in the right lower quadrant, chills, and a fever reaching 39.0°C. The patient had anemia, hypocoagulation and immunodeficiency. Ultrasound and CT scans of the abdominal organs revealed an abscess in the right iliac region. It was immediately drained under ultrasound control and X-ray. A fistulogram showed the fistula between the abscess and the ileum. Routine antibiotic therapy selected in accordance with the sensitivity of the microflora and sanitization of the abscess cavity were not effective. The immunomodulatory therapy, intravenous administration of cryoprecipitate, and the introduction of fibrin glue into the abscess cavity were added to the treatment. After the treatment, the patient's immune status corresponded to normal, the abscess healed, and the fistula was closed.Conclusion: In patients suffering from Crohn's disease with the formation of an abscess and a long-term non-healing intestinal fistula, it is essential that the diagnostic algorithm includes the examination of the immune status. Treatment should include immunomodulators, intravenous administration of cryoprecipitate. To close the fistula in these patients, it is advisable to use fibrin glue that has a local immunomodulatory effect.

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.

Immune status in healthy relatives of patients with familial Crohn's disease

1988 ◽  
Vol 33 (8) ◽  
pp. 945-950 ◽  
Author(s):  
A. Van Gossum ◽  
E. Dupont ◽  
L. Schandene ◽  
M. Cremer ◽  
J. Wybran
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Immune Status

Clinical experience and diagnostic algorithm of vulval Crohn’s disease

2017 ◽  
Vol 29 (7) ◽  
pp. 838-843 ◽  
Author(s):  
Lotte Boxhoorn ◽  
Tom J. Stoof ◽  
Tim de Meij ◽  
Frank Hoentjen ◽  
Bas Oldenburg ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Experience ◽  
Diagnostic Algorithm

The Influence of Vitamin C and Zinc on Immune Status in Crohn's Disease

1986 ◽  
Vol 71 (s15) ◽  
pp. 72P-72P
Author(s):  
A. Animashaun ◽  
R. V. Heatley ◽  
J. Kelleher ◽  
M. S. Losowsky
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Vitamin C ◽  
Immune Status

scholarly journals Castleman's Disease and Neutropenic Enterocolitis Presenting as Crohn’s Disease

1998 ◽  
Vol 12 (4) ◽  
pp. 270-272 ◽  
Author(s):  
Kelly W Burak ◽  
Ronald J Bridges ◽  
Walter B Blahey
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Castleman’S Disease ◽  
Castleman's Disease ◽  
Ileocecal Region ◽  
Lower Quadrant ◽  
Neutropenic Enterocolitis ◽  
Right Lower Quadrant Pain ◽  
One Year

A rare case of Castleman's disease presenting as Crohn's disease is described. This 21-year-old male with chronic neutropenia for one year presented with recurrent right lower quadrant pain of two years' duration. Small bowel follow-through suggested Crohn's of the terminal ileum. Colonoscopy confirmed ulcerations in the terminal ileum and cecum, with biopsies showing necrosis and inflammation. Treatment was initiated with prednisone, 5-aminosalicylate and granulocyte colony-stimulating factor for neutropenia. Symptoms recurred one year later, and repeat colonoscopy showed a focal cecal ulceration. Two years after presentation a resection was planned. Laparotomy revealed a normal ileocecal region and a large retroperitoneal mass of lymphadenopathy. Biopsies confirmed reactive hyperplasia, consistent with the plasma cell variant of Castleman's disease. Chemotherapy has resulted in improvement of symptoms and decrease in mass size, but cecal ulceration persisted. This case illustrates a variant presentation of Castleman's disease with neutropenia and manifestations in the gastrointestinal tract.

scholarly journals Cutaneous Vasculitis, Interstitial Pneumonia with Crazy-Paving Appearance, and Positive pANCA in a Patient with Severe Crohn’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Guang-liang Chen ◽  
Juan Wang ◽  
Bao-zhen Li ◽  
Li-mei Li ◽  
Han-you Mo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Interstitial Pneumonia ◽  
Chinese Patient ◽  
Cutaneous Vasculitis ◽  
High Resolution Computed Tomography ◽  
Lower Quadrant ◽  
Inflammatory Bowel ◽  
Right Lower Quadrant

Cutaneous vasculitis, interstitial pneumonia with crazy-paving appearance on high-resolution computed tomography, and repeated positive perinuclear anti-neutrophil cytoplasmic antibodies (pANCA) are rarely found together in patients with inflammatory bowel disease in the existing literature. We report the case of a Chinese patient previously diagnosed with cutaneous vasculitis and interstitial pneumonia, who presented with acute pain and mass in his right lower quadrant a couple of years later. The terminal ileum biopsy and postoperative pathology confirmed Crohn’s disease (CD).

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