Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Progressive symptoms of caudal compression (flaccid paraparesis, sensory disorders), accompanied by severe pain and fever, developed over a few days in a 26-year-old man with Crohn's disease for 11 years. Spinal computed tomography, performed under the diagnosis of herniated disc, revealed intraspinal soft tissue, as well as gas in the spinal canal (L2-S3) and the paravertebral muscles. This led to the diagnosis of acute epidural abscess and a laminectomy was performed (at L4-S2). Intraspinally there was thickened, bluish fatty tissue; thick pus exuded between dura and the sacral roots. Suction-irrigation of the spinal canal was undertaken via an epidural drain. Postoperative contrast infusion into the colon demonstrated a fistula directed towards the sacrum. The postoperative course was complicated by severe respiratory impairment of which the patient died.--Epidural abscess is a rare complication of Crohn's disease. Because of its poor prognosis early diagnosis with magnetic resonance imaging or computed tomography should be undertaken in every patient with Crohn's disease who has back pain, fever or, particularly, symptoms of spinal compression.
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PMID:[An epidural spinal abscess with caudal symptoms as a complication of Crohn's disease]. 183 49

Psoas abscess is a very rare complication in pregnancy. It creates difficulties in diagnosis and treatment. In our patient pain, fever, leukocytosis and Magnetic Resonance Imaging led to the diagnosis. It was the first manifestation of Crohn's disease.
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PMID:[Psoas abscess in pregnancy: a case report]. 188 33

Two patients with Crohn's disease who developed squamous cell carcinoma in chronic sinus tracts are reported. Because nonhealing perineal sinus tracts or fistulas are relatively common in patients with Crohn's disease, the diagnosis of carcinoma may not be considered until the malignancy is advanced. Because of the potential for a surgical and oncologic "cure," early diagnosis may improve the prognosis. Malignancy should be considered in patients with nonhealing perineal sinuses who develop severe continuous perianal pain. Diagnosis is best made by needle aspiration cytology and sinus tract biopsy. Treatment should include wide excision of the sinus tract, surrounding soft tissue, and lymph nodes, followed by chemotherapy and radiotherapy in selected cases.
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PMID:Development of squamous cell carcinoma in chronic perineal sinus and wounds in Crohn's disease. 196 32

There are three main groups of indications of lower digestive tract endoscopy: (1) endoscopy may be performed to detect adenomatous polyps and thus prevent colorectal cancer by systematic excision of these polyps before they become invasive malignancies; (2) it may also be performed in patients whose symptoms (e.g. pain, diarrhoea or anaemia) may be due to a lesion of the colon. It usually provides evidence of such diseases as colorectal adenocarcinoma, ulcerative colitis, Crohn's disease, pseudomembranous colitis, post-irradiation colitis, collagen colitis, ischaemic colitis or colonic angiodysplasia; (3) finally, emergency endoscopy can be used in case of rectal haemorrhage, where it is often completed by haemostasis, or in case of volvulus, where it removes the occlusion.
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PMID:[The main indications for lower endoscopies]. 200 76

We report four new cases of oral manifestation in Crohn's disease (CD) and evaluate 75 reported cases for morphology and site of oral and intestinal manifestations of CD, clinical manifestation, and treatment. Oral CD was the presenting symptom in 43 of 72 (60%) patients and relapsed in 34 of 60 (57%). Median age at presentation was 22 (range 6-57) years, and males were affected more often (1.85:1, male:female ratio). From a total of 228 oral lesions in 79 patients, lips (57 lesions), gingiva (40 lesions), vestibular sulci (31 lesions), and buccal mucosa (25 lesions) were the sites most frequently affected. Edema (62 lesions), ulcers (57 lesions), and polypoid papulous hyperplastic mucosa (45 lesions) were the most common type of lesions. The rate of granuloma detection was high in oral (67-77%) and intestinal lesions (45-71%). A total of 66 courses of drug therapy in 51 patients were analyzed. Complete remission of oral symptoms was achieved by systemic steroids and/or azathioprine in 13 of 26 (50%) patients, whereas strictly topical treatment with steroids resulted in complete remission of oral symptoms in 7 of 12 (58%). We conclude that oral CD exhibits a characteristic morphologic appearance, as often as not preceding intestinal symptoms in adolescents and young adults. Thus, patients with orofacial granulomatosis CD should be vigorously searched for by complete gastrointestinal endoscopic investigation. Oral CD may cause disabling pain and facial distortion, and results of treatment remain unrewarding. In the absence of data from controlled therapeutic trials, systemic steroids and/or azathioprine are recommended if topical treatment has failed to control symptoms.
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PMID:Oral manifestations of Crohn's disease. An analysis of 79 cases. 200 40

A patient with renal colicky pain caused by urinary tract obstruction, as a result of psoas abscess, is presented. It was the first manifestation of Crohn's disease. A Gram negative bacteria was isolated from the abscess. The CT images performed to evaluate the abscess suggested this etiology, even though there were no previous symptoms.
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PMID:[Obstructive uropathy as initial manifestation of Crohn disease]. 210 98

The records of 102 patients operated on by one of the authors for Crohn's disease during the past 15 years were reviewed. Twenty-seven patients with confined (abscess present) or free perforation were evaluated. The average age was 31 years and the mean duration of disease was four years. Only two of the 27 patients had had previous surgery. All patients presented with a combination of pain, weight loss, and diarrhea. Twenty-three patients were afebrile, 17 had abdominal tenderness, and 6 had an abdominal mass. The average serum albumin was 3.7, the average hematocrit was 35 per cent and the average WBC was 13,000. Radiologic tests were abnormal in 23 of the 27 patients. All patients had been on medical treatment for Crohn's disease, and 19 of 27 were on high-dose steroids at the time of surgery. Ten of the 27 had a bowel prep before surgery and all had preoperative and postoperative antibiotics. All patients were surgically managed by resection and primary anastomosis without proximal diversion or delayed reconstruction. Drains were used in one third of the patients. Intraoperative cultures revealed gram-negative rods with Escherichia coli, enterococcus, and Enterobacter the most common. One enterocutaneous fistula, two superficial wound infections, and one death were recorded. Based on these results, the authors believe that an aggressive one-stage surgical approach for these complicated problems can be recommended. The low morbidity and mortality justifies this approach that results in considerable improvement in lost work time, length of hospital stay, number of readmissions, and significant cost control.
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PMID:Surgical management of perforated Crohn's disease. 230 51

Inflammation occurring in a defunctionalized portion of bowel, following either ileostomy or colostomy, has long been recognized by endoscopists. However, little has been written about this entity, particularly the histopathologic changes. Glotzer et al in 1981 described 10 cases, and coined the term "diversion colitis". We studied 21 patients without previous history of inflammatory bowel disease who, for reasons including perforated diverticulitis, carcinoma, or trauma, had loop colostomies or Hartmann's procedure performed. Many of these patients became symptomatic with complaints related to the defunctionalized bowel, including rectal discomfort, pain, discharge, and bleeding. Nineteen patients had endoscopic examinations, which revealed a variety of findings including mucous plugs, friability, petechia, erythema, ulcers, exudate, and nodules or polyps. All except one case had tissue from the excluded portions of bowel available for pathologic examination. Most displayed nonspecific changes with mild-to-moderate lymphoplasmacytic infiltrates in the lamina propria, mild architectural alterations of the crypts, and slight decrease in crypt numbers. Ulceration, cryptitis, and crypt abscesses simulating ulcerative colitis were uncommon findings and were observed almost exclusively in more severe cases. Granulomas were observed in two cases, raising the possibility of Crohn's disease.
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PMID:Diversion colitis: a clinicopathologic study of 21 cases. 231 85

Fistulization to the duodenum or stomach from a diseased segment of bowel in Crohn's disease is rare, with only 63 cases reported. We report an additional two cases of Crohn's disease with recurrent fistulization to the duodenum. Although one or both patients complained of pain, diarrhea, and/or weight loss at presentation, neither of them experienced vomiting or feculent eructation. A review of 46 of the 63 reported cases of gastric and duodenal fistulization indicated that patients with gastric fistulas commonly present with vomiting (39%), and with histories of feculent eructations or frank feculent vomiting (44%), but that patients with duodenal fistulas rarely present with vomiting (3.6%), and never have feculent vomiting or eructations. This difference is an important clue to the diagnosis and localization of upper gastrointestinal fistulas in Crohn's disease.
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PMID:Symptomatic differentiation of duodenal from gastric fistulas in Crohn's disease. 232 89

A patient with Crohn's disease of the colon developed severe abdominal pain after salicylicazosulfapyridine and after disodium azodisalicylate therapy. Raised serum and urinary amylase levels were found after disodium azodisalicylate. Rechallenge with disodium azodisalicylate caused a recurrence of the pain and of the elevated amylase levels. The time course of these episodes was compatible with 5-aminosalicylate-induced pancreatitis.
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PMID:Pancreatitis induced by disodium azodisalicylate. 245 67


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