Reactivation of Crohn’s colitis in an adolescent following serial autologous fecal transplants for diversion colitis: A case report with multiomic characterization

Autologous fecal transplant (AFT, transfer of ileostomy feces to the colon) for diversion colitis (DC) has not yet been described in children or adolescents. We performed serial AFTs in a 16-year-old with Crohn’s disease and DC. As evidenced by endoscopic, histologic, laboratory, and multiomic profiling of the colon, the first AFT led to interval improvement in DC, whereas the second AFT reactivated Crohn’s colitis. These findings ultimately guided shared decision-making towards total colectomy.

Atypical case of Crohn’s colitis in a patient with adult-onset Still’s disease

A 65-year-old woman with a background of adult-onset Still’s disease (AOSD) presented acutely to a general surgical unit with signs of bowel obstruction and sepsis. A CT scan was indicative of a mesenteric lymphadenopathy suspicious of malignancy. At the time of the surgery, a clinical diagnosis of lymphoma was made given the large number of lymph nodes; however, histological diagnosis was resulted as Crohn’s colitis. There is only one other case of AOSD and Crohn’s disease in the literature, and there is no clear pathological connection between the two inflammatory conditions. This case highlights the surgical management of an unusual presentation.