Crohn's disease complicated by multiple stenoses and internal fistulas clinically mimicking small bowel endometriosis

Zafer Teke, Aytekin FO, Faruk Onder Aytekin, Faruk Önder Aytekin, Ali Ozgur Atalay, Atalay AO, Nese Calli Demirkan, Neşe Çallı Demirkan
World journal of gastroenterology · 2008 · vol. 14(1) , pp. 146 · doi:10.3748/wjg.14.146 · PMID:18176980 · PMC2673382 · W2157761200
Case report OA: hybrid CC0 ⤵ 25 in-corpus citations
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This case report details a patient with Crohn's disease presenting with stenoses and fistulas that mimicked small bowel endometriosis due to cyclical obstructive symptoms.

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Abstract

We report a 31-year-old woman with Crohn's disease complicated by multiple stenoses and internal fistulas clinically misdiagnosed as small bowel endometriosis, due to the patient's perimenstrual symptoms of mechanical subileus for 3 years; at first monthly, but later continuous, and gradually increasing in severity. We performed an exploratory laparotomy for small bowel obstruction, and found multiple ileal strictures and internal enteric fistulas. Because intraoperative findings were thought to indicate Crohn's disease, a right hemicolectomy and partial distal ileum resection were performed for obstructive Crohn's ileitis. Histopathology of the resected specimen revealed Crohn's disease without endometrial tissue. The patient made an uneventful recovery from this procedure and was discharged home 10 d post-operatively. The differential diagnosis of Crohn's disease with intestinal endometriosis may be difficult pre-operatively. The two entities share many overlapping clinical, radiological and pathological features. Nevertheless, when it is difficult to identify the cause of intestinal obstruction in a woman of child-bearing age with cyclical symptoms suggestive of small bowel endometriosis, Crohn's disease should be included in the differential diagnosis.

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Condition tags

endometriosisbowel_endometriosis

MeSH descriptors

Crohn Disease Crohn Disease Endometriosis Intestinal Fistula Intestinal Fistula Adult Adult Constriction, Pathologic Constriction, Pathologic Crohn Disease Crohn Disease Diagnosis, Differential Diagnosis, Differential Endometriosis Endometriosis Female Female Humans Humans Intestinal Fistula

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (35)

Cited by (26)

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License: CC0 · commercial use OK