Tuesday Advanced Cases

Advanced Cases – Complications of IBD!

Allison Cash M.D.

HPI

  • 42 year old male with history of Crohn’s
  • Presented with 5 days LLQ pain, fevers, chills, diarrhea
  • Denied hematochezia/melena, vomiting

Physical Exam

  • BP 136/82  | Pulse 77  | Temp 98.1 °F (36.7 °C) (Oral)  | Resp 16  | SpO2 98%
  • Exam: patient uncomfortable appearing, LLQ pain with no rebound or guarding

Work-up

  • CBC, BMP unremarkable
  • CT A/P with bowel wall thickening and multiple pericolonic abscesses

Hospital Course

  • Patient admitted to surgery and started on IV Zosyn
  • IR consulted for abscess drainage
  • Transitioned to oral Augmentin, diet advanced, discharge home

IBD complications pearls

References:

  1. Judith E. Tintinall, et al. (2020). Tintinalli’s Emergency Medicine : A Comprehensive Study Guide (Ninth Edition). New York: McGraw-Hill.
  2. Maaser C, Sturm, et al. European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR] ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 2019 Feb 01;13(2):144-164.

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