Cases reported "Crohn Disease"

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1/57. Coincidence of Crohn's disease and a high-risk gastrointestinal stromal tumor of the terminal ileum.

    A 51-year-old male patient presented with characteristic radiologic features of Crohn's disease in the terminal ileum plus a large tumorous lesion in the right lower abdomen. Because of rapid crescent symptoms of bowel obstruction, the patient underwent surgery revealing a high-risk gastrointestinal stromal tumor (GIST) of the terminal ileum within an area of Crohn's ileitis. Whereas the association of chronic inflammatory bowel disease (IBD) and gastrointestinal adenocarcinoma is well known, other primary intestinal tumors are rare in these patients, particularly at the time of onset of clinical symptoms. This is the 3rd patient reported in the literature with a sarcoma complicating IBD, and in fact, the first description of the coincidence of Crohn's disease and GIST. Though the present case is likely to be a mere coincidence of two pathologically distinct entities (without any potential causal relationship), it should remind one of the possibility of small bowel 'Crohn's carcinoma' in patients with a sudden change in symptomatology as well as in those in whom intestinal obstruction fails to resolve with adequate therapy.
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keywords = ileitis
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2/57. Diffuse duodenitis associated with ulcerative colitis.

    Backwash ileitis and postcolectomy pouchitis are well-recognized complications of ulcerative colitis (UC), whereas inflammation of the proximal small intestine is not. In contrast, small intestinal disease at any level is common in Crohn's disease (CD). Despite this well-established and accepted dogma, rare cases of histologically proven diffuse duodenitis (DD) associated with UC appear in the literature. In this study, we report our experience with similar cases exhibiting this unusual inflammatory phenomenon. Routine histologic sections from four cases of DD associated with well-documented UC were reviewed and the findings correlated with all available medical records. Multiple endoscopic biopsies showing histologic features of UC and colectomy specimens confirming severe ulcerative pancolitis were available for all cases. Varying degrees of active chronic inflammation and architectural mucosal distortion identical to UC were observed in pre- and postcolectomy duodenal biopsies of one of four and four of four cases, respectively. Similar inflammatory patterns were present postoperatively in the ileum in three of four cases and in the jejunum in one case. Endorectal pull-through (ERPT) procedures were performed in three of four patients and an end-to-end ileorectal anastomosis was done in one patient. Despite extensive upper gastrointestinal tract involvement, none of the patients developed postsurgical Crohn's-like complications during a follow-up period of 12 to 54 months. This suggests that patients with pancolitis and DD do not necessarily have CD, but rather may have UC and, most importantly, that successful ERPT procedures may be performed in these patients.
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ranking = 1
keywords = ileitis
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3/57. Acute terminal ileitis associated with pneumococcal bacteremia: case report and review of pneumococcal gastrointestinal diseases.

    In this report, we describe a patient with acute terminal ileitis due to streptococcus pneumoniae, review 3 previously reported cases of isolated enteritis due to S. pneumoniae, and summarize the English-language literature on primary and secondary pneumococcal gastrointestinal diseases. Various theories have been advanced to explain the pathogenesis of this rare and potentially life-threatening form of pneumococcal infection, but the mechanism by which S. pneumoniae causes gastrointestinal disease is still unknown.
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ranking = 5
keywords = ileitis
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4/57. Ulcerative terminal ileitis after BCG therapy for bladder carcinoma.

    AIM: We evaluated the aetiology of ulcerative ileitis in a 77-year-old patient receiving BCG therapy for recurring bladder carcinoma. methods AND RESULTS: Histological examination, laboratory data and the clinical history allowed us to exclude a classical cause such as Crohn's disease, tuberculosis or ischaemia. The important locoregional reaction suggests a BCG ileitis of the terminal ileum. Intestinal BCG ileitis has been exceptionally described after BCG vaccination. CONCLUSION: Our observation of ulcerative ileitis indicates that a digestive tract location is possible as a reaction to BCG therapy.
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ranking = 8
keywords = ileitis
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5/57. A new model of strictureplasty for multiple and long stenoses in Crohn's ileitis: side-to-side diseased to disease-free anastomosis.

    Conservative surgery has become the treatment of choice for diffuse jejunoileal Crohn's Disease. Previous research described a conservative approach both for multiple strictures located in close proximity to each other and for long stenoses. The side-to-side enteroenteric anastomosis has gained popularity and has lead to nonresectional surgery even for those patients who, until now, were considered suitable only for resection. This technique however, presents in our hands some disadvantages represented mainly by early restenosis at the two edges of the strictureplasty, probably caused by the sutures between the diseased and the thickened part of the bowel. We propose a new technique called "side-to-side diseased to disease-free anastomosis," which consists of dividing the bowel and the mesentery at the beginning of the stenoses and suturing the disease-free bowel above the stenoses to the diseased bowel. This procedure could avoid early restenosis at the two ends of the strictureplasty. Moreover, it is faster and safer to perform because the knots of the sutures are tied to the normal bowel with less risk of bleeding.
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ranking = 4
keywords = ileitis
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6/57. An unusual way to diagnose a rare case of bladder carcinoma in a patient with Crohn's disease.

    BACKGROUND AND AIMS: Crohn's disease of unknown etiology may involve the urinary tract and may include a mass lesion on cystoscopy. patients AND RESULTS: We present an unusual case of asymptomatic urinary bladder carcinoma in a patient undergoing surgery for Crohn's ileitis.
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ranking = 1
keywords = ileitis
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7/57. Studies on Crohn's disease. 1. The relationship between yersinia enterocolitica infection and terminal ileitis.

    patients with terminal ileitis or regional enterocolitis have been examined for signs of infection due to yersinia enterocolitica serotype 3. The patients were grouped according to the length of preoperative history. Among 18 patients with preoperative symptoms of one week or less there were nine with positive signs of yersinia enterocolitica infection. None of these patients developed the chronic form of Crohn's disease while two of the primarily Yersinia negative patients progressed to the chronic form. Among nine patients with preoperative symptoms of one week to three months there was one patient with positive signs of yersinia enterocolitica infection. This patient has remained healthy whereas seven of the negative ones progressed to the chronic form of Crohn's disease. None of the patients with established Crohn's disease of the chronic form had signs of recent Yersinia infection. The findings indicate that patients with acute terminal ileitis and positive signs of Yersinia infection are not likely to progress to the chronic form of Crohn's disease. Bacteriologic and serologic investigation for Yersinia infection are therefore of prognostic value.
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ranking = 6
keywords = ileitis
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8/57. ileitis due to yersinia pseudotuberculosis in Crohn's disease.

    We present the case of a young woman with fulminating terminal ileitis due to yersinia pseudotuberculosis, in whom Crohn's disease was subsequently diagnosed. Serological testing was prompted by radiological, macroscopic and histological changes which were atypical of Crohn's disease. We speculate that Y. pseudotuberculosis ileitis may occasionally produce an acute exacerbation of Crohn's disease, but that its occurrence may not be diagnosed if the atypical features are not recognised. In this case, the classical features of Y. pseudotuberculosis may have been modified by pre-existing Crohn's disease. We propose that, because of defects in mucosal barrier function and immunological function, patients with Crohn's may have increased susceptibility to infection by Yersinia sp.
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ranking = 2
keywords = ileitis
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9/57. Neuropathy related to Crohn's disease treated by peripheral nerve decompression.

    Neurological complications of Crohn's ileitis have been reported, and the aetiology ascribed to vitamin deficiencies and iatrogenic treatment. In this report we describe a patient who developed multiple areas of nerve compression in lower and upper extremities. After failure of conservative treatment, she was successfully treated surgically. As far as we know this has not been reported before.
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ranking = 1
keywords = ileitis
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10/57. Scalloping of duodenal mucosa in Crohn's disease.

    Scalloping of the duodenal mucosal folds is an endoscopic finding of small bowel mucosal pathology that is generally due to villous atrophy. Though it can be seen in many disease processes, it is most commonly associated with celiac disease. We report three patients with scalloping of duodenal folds and histologic confirmation of villous atrophy due to Crohn's disease. All patients had negative celiac serologies and two had positive markers for Crohn's disease (anti-saccharomyces cerevisiae antibodies). patients had either ileitis or ileocolitis in addition to duodenal abnormalities. These cases illustrate that scalloping can occur in the duodenum in Crohn's disease.
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ranking = 1
keywords = ileitis
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