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:
- Judith E. Tintinall, et al. (2020). Tintinalli’s Emergency Medicine : A Comprehensive Study Guide (Ninth Edition). New York: McGraw-Hill.
- 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.