Abstract
Amaç: Crohn hastalığı, çocuklarda giderek yaygınlaşan bir sağlık sorunudur. Bu hastalar uygun tedavi veya tedavi edilmediği takdirde komplikasyonlara sebep olabilmektedir. Bu çalışmada Crohn hastalığında şüphelenilen ve pelvik bölgede inflamasyon ile başvuran olgu literatür ile değerlendirilmiştir. Olgu: Crohn hastalığı şüphesi olan 11 yaşında kız hasta fakat yapılan laboratuvar testlerinde ve endoskopi ile alınan biyopsi ile tanı konulamamıştır. Bir buçuk ay antibiyotik kullanmasına rağmen karın içi inflamasyonu, abse ve enteroenterik fistülü devam etmiştir. Tanı için bize refere edilen hasta, Crohn hastalığı ön tanısıyla ameliyata alındı. Hastanın ameliyattaki makroskobik bulgular ve patoloji Crohn hastalığı ile uyumluydu. Sonuç: Cerrahi bazı koşullarda Crohn hastalığının tedavisi ve teşhisi için endikedir. Crohn hastalığının tedavisi multidsipliner bir ekip gerektirir.
Keywords
References
- Kulungowski AM, Acker SN, Hoffenberg EJ et al. Initial operative treatment of isolated ileal Crohn’s disease in adolescents. Am J Surg. 2014. pii: S0002-9610(14)00505-4.
- Lee KM, Lee JM. Crohn’s disease in Korea: past, present, and future. Korean J Intern Med. 2014;29:558-70.
- Pariente B, Laharie D. Review article: why, when and how to de- escalate therapy in inflammatory bowel diseases. Aliment Pharmacol Ther. 2014;40:338-53.
- Mantzaris GJ. When can we cure Crohn’s? Best Pract Res Clin Gastroenterol. 2014;28:519-29.
- Benchimol EI, Fortinsky KJ, Gozdyra P, et al. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis. 2011;17:423-39.
- Ruemmele FM, Veres G, Kolho KL, et al.Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric. Crohn’s disease.J Crohns Colitis. 2014;8:1179-207.
- Nielsen OH, Rogler G, Hahnloser D, et al. Diagnosis and management of fistulizing Crohn’s disease.Nat Clin Pract Gastroenterol Hepatol. 2009;6:92-106.
- Su YR, Shih IL, Tai HC, et al. Surgical management in enterovesical fistula in Crohn disease at a single medical center. Int Surg. 2014;99:120-5.
- Golovics PA, Lakatos L, Nagy A, et al. Is early limited surgery associated with a more benign disease course in Crohn’s disease? World J Gastroenterol. 2013 Nov 21;19:7701-10.
- Aratari A, Papi C, Leandro G, et al.Early versus late surgery for ileo- caecal Crohn’s disease.Aliment Pharmacol Ther. 2007;26(10).
- Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. 1932. Mt Sinai J Med. 2000;67:263-8.
- Benchimol EI, Mack DR, Nguyen GC,et all. Incidence, outcomes, and health services burden of very early onset inflammatory bowel disease. Gastroenterology. 2014;147:803-13.
- Mosli M, Al Beshir M, Al-Judaibi B, et al. Advances in the diagnosis and management of inflammatory bowel disease: challenges and uncertainties.Saudi J Gastroenterol. 2014;20:81-101.
- Abraham BP, Mehta S, El-Serag HB. Natural history of pediatric- onset inflammatory bowel disease: a systematic review.J Clin Gastroenterol. 2012;46:581-9.
- Antunes O, Filippi J, Hébuterne X, et al.Treatment algorithms in Crohn’s - up, down or something else? Best Pract Res Clin Gastroenterol. 2014;28:473-83.
- Yamamoto T, Watanabe.Surgery for luminal Crohn’s disease.World J Gastroenterol. 2014;20:78-90.
- Latella G, Cocco A, Angelucci E, et al.Clinical course of Crohn’s disease first diagnosed at surgery for acute abdomen.Dig Liver Dis. 2009;41:269-76.
Abstract
Objectives: Crohn’s disease is an increasingly common health problem in children. If untreated or treated inappropriately, it eventually results in complications. This report presents a case of suspected Crohn’s disease with inflammation of the pelvic region with a review of the literature. Case: An 11-year-old female was suspected of having Crohn’s disease, but laboratory tests and biopsy by endoscopy failed to confirm the diagnosis. She had intra-abdominal inflammation, an enteroenteric fistula, and an abscess that did not resolve despite antibiotic treatment for 1.5 months. She was referred to us for diagnosis. We performed surgery with a provisional diagnosis of Crohn’s disease; the pathology was consistent with Crohn’s disease. Conclusion: Surgery is indicated for the therapy and diagnosis of Crohn’s disease under certain conditions. The treatment of Crohn’s disease requires a multidisciplinary team.
Keywords
References
- Kulungowski AM, Acker SN, Hoffenberg EJ et al. Initial operative treatment of isolated ileal Crohn’s disease in adolescents. Am J Surg. 2014. pii: S0002-9610(14)00505-4.
- Lee KM, Lee JM. Crohn’s disease in Korea: past, present, and future. Korean J Intern Med. 2014;29:558-70.
- Pariente B, Laharie D. Review article: why, when and how to de- escalate therapy in inflammatory bowel diseases. Aliment Pharmacol Ther. 2014;40:338-53.
- Mantzaris GJ. When can we cure Crohn’s? Best Pract Res Clin Gastroenterol. 2014;28:519-29.
- Benchimol EI, Fortinsky KJ, Gozdyra P, et al. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis. 2011;17:423-39.
- Ruemmele FM, Veres G, Kolho KL, et al.Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric. Crohn’s disease.J Crohns Colitis. 2014;8:1179-207.
- Nielsen OH, Rogler G, Hahnloser D, et al. Diagnosis and management of fistulizing Crohn’s disease.Nat Clin Pract Gastroenterol Hepatol. 2009;6:92-106.
- Su YR, Shih IL, Tai HC, et al. Surgical management in enterovesical fistula in Crohn disease at a single medical center. Int Surg. 2014;99:120-5.
- Golovics PA, Lakatos L, Nagy A, et al. Is early limited surgery associated with a more benign disease course in Crohn’s disease? World J Gastroenterol. 2013 Nov 21;19:7701-10.
- Aratari A, Papi C, Leandro G, et al.Early versus late surgery for ileo- caecal Crohn’s disease.Aliment Pharmacol Ther. 2007;26(10).
- Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. 1932. Mt Sinai J Med. 2000;67:263-8.
- Benchimol EI, Mack DR, Nguyen GC,et all. Incidence, outcomes, and health services burden of very early onset inflammatory bowel disease. Gastroenterology. 2014;147:803-13.
- Mosli M, Al Beshir M, Al-Judaibi B, et al. Advances in the diagnosis and management of inflammatory bowel disease: challenges and uncertainties.Saudi J Gastroenterol. 2014;20:81-101.
- Abraham BP, Mehta S, El-Serag HB. Natural history of pediatric- onset inflammatory bowel disease: a systematic review.J Clin Gastroenterol. 2012;46:581-9.
- Antunes O, Filippi J, Hébuterne X, et al.Treatment algorithms in Crohn’s - up, down or something else? Best Pract Res Clin Gastroenterol. 2014;28:473-83.
- Yamamoto T, Watanabe.Surgery for luminal Crohn’s disease.World J Gastroenterol. 2014;20:78-90.
- Latella G, Cocco A, Angelucci E, et al.Clinical course of Crohn’s disease first diagnosed at surgery for acute abdomen.Dig Liver Dis. 2009;41:269-76.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | March 1, 2016 |
| Published in Issue | Year 2016Issue: 1 |