Small Bowel Volvulus as Delayed Presentation of Undiagnosed Crohn's Disease: A Case Report.

Autor:	Nguyen MTT; University of Rochester Medical Center, Department of Internal Medicine, Rochester, New York., Ali A; University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York., Bodkin RP; University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York.
Jazyk:	angličtina
Zdroj:	Clinical practice and cases in emergency medicine [Clin Pract Cases Emerg Med] 2021 Nov; Vol. 5 (4), pp. 455-458.
DOI:	10.5811/cpcem.2021.8.53524
Abstrakt:	Introduction: Emergency department (ED) visits related to flare-ups of inflammatory bowel disease (IBD) are becoming more prevalent. There are many potentially dangerous complications and sequelae of uncontrolled IBD. Case Report: We report a case of a middle-aged woman who presented with a few hours of severe abdominal pain, nausea, and vomiting. Given her hemodynamic instability, she was sent urgently for computed tomography, which showed an incomplete small bowel malrotation, mesenteric volvulus, and high-grade small bowel obstruction with evolving ischemia. The patient underwent exploratory laparotomy to resect most of her small intestines. Biopsies later revealed active Crohn's disease. Conclusion: Patients with flare-ups of IBD are common in the ED, but very few present with a midgut volvulus later in life. Our case is unique and adds to the literature due to the dramatic consequences of undiagnosed Crohn's disease in a patient with intermittent symptoms and extensive workup spanning over two decades.
Databáze:	MEDLINE
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