Coincidence of active Crohn's disease and florid endometriosis in the terminal ileum: A case report

Elke Kaemmerer, Maren Westerkamp, Reinhard Kasperk, Gerhard Niepmann, Axel Scherer, Nikolaus Gassler
World journal of gastroenterology · 2013 · vol. 19(27) , pp. 4413 · doi:10.3748/wjg.v19.i27.4413 · PMID:23885155 · W2057311518
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This case report describes a 35-year-old woman with florid intestinal endometriosis intermingled with florid Crohn's disease in the terminal ileum, suggesting a complex relationship between the two conditions.

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Abstract

Crohn's disease (CD), a variant of chronic inflammatory bowel disease, frequently affects the terminal ileum and coecal region. The clinical symptoms are often subtle and depend on the inflammatory activity of disease. In women of child-bearing age, florid intestinal endometriosis can simulate CD. Moreover, current pathophysiological concepts include intestinal endometriosis as a putative founder lesion for consecutive CD establishment. The report summarizes clinical and histomorphological data of a 35-year-old woman with the rare coincidence of florid intestinal endometriosis and CD both affecting the terminal ileum. The patient was suffering over 10 years from strong abdominal disorders including constipation, diarrhea, weight loss, and diffuse abdominal pain. In magnetic resonance imaging-Sellink, strong inflammation and intestinal obstruction of the terminal ileum were found. The laparoscopy revealed further evidence for existence of an inflammatory disease like CD, but brownish spots on the peritoneum were found indicative for endometriosis. Surgical resection of the terminal ileum and the coecal segment was performed followed by histopathological investigations. In transmural sections of the terminal ileum, histomorphological features of florid endometriosis intermingled with florid CD was found. The diagnostic findings were substantiated with a panel of immunohistological stainings. In conclusion, the findings demonstrate that florid endometriosis persists in florid CD lesions and the putative link between intestinal endometriosis and CD is more complex than previously assumed.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Crohn Disease Crohn Disease Endometriosis Endometriosis Ileum Adult Crohn Disease Crohn Disease Endometriosis Endometriosis Female Humans Ileum Ileum Immunohistochemistry Inflammation Intestinal Diseases Intestinal Diseases Laparoscopy Magnetic Resonance Imaging

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (12)

Cited by (9)

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