A Case Report and Literature Review of Rectosigmoid Crohn's Disease: A Diagnostic Pitfall Ultimately Leading to Spontaneous Colonic Perforation

Inflammatory bowel disease (IBD) is a chronic condition that affects the gastrointestinal tract, with ulcerative colitis (UC) and Crohn's disease (CD) as the two major entities. While these conditions share some similarities in clinical presentation, they have distinct histopathological feature...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-03, Vol.15 (3), p.e36941
Main Authors: Ali, Sr, Muhammad Z, Tariq, Muhammad Usman, Abid, Muhammad Hasan, Abdulaziz, Hamma, AlAdwani, Mohmmad, Khurshid, Arif, Rashid, Muhammad, Al Thobaiti, Fawaz, Althagafi, Amjad
Format: Article
Language:English
Subjects:
Abdomen
Abscesses
Antibodies
Biopsy
Blood pressure
Case reports
Colon
Colonoscopy
Crohn's disease
Diarrhea
Emergency medical care
Endoscopy
Gastroenterology
General Surgery
Hematology
Hemoglobin
Inflammation
Inflammatory bowel disease
Iron
Laboratories
Laparotomy
Medical diagnosis
Medical imaging
Ostomy
Pathology
Patients
Pelvis
Peritonitis
Proteins
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Summary:Inflammatory bowel disease (IBD) is a chronic condition that affects the gastrointestinal tract, with ulcerative colitis (UC) and Crohn's disease (CD) as the two major entities. While these conditions share some similarities in clinical presentation, they have distinct histopathological features. UC is a mucosal disease affecting the left colon and rectum, while CD can affect any part of the gastrointestinal tract and all layers of the bowel wall. Accurate diagnosis of UC and CD is important for effective management and prevention of complications. However, distinguishing between the two conditions based on limited biopsy specimens or atypical clinical presentations can be challenging. We present a case of a patient diagnosed with UC based on a single endoscopic biopsy from the sigmoid colon, who later presented with colonic perforation and was found to have CD on the colectomy specimen. This case emphasizes the importance of clinical guidelines when dealing with any patient of suspected IBD, considering alternative diagnoses in patients with atypical presentations and the need for careful clinical, endoscopic, and histological evaluation to make an accurate diagnosis. Delayed or missed diagnosis of CD can lead to significant morbidity and mortality.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.36941