C/O : Abdominal pain. Dx?

A 35-year-old male with history of Crohn’s disease presented to ED with abdominal pain. X-ray is attached below? What are the interpretations? What other tests are needed? What are the treatment options?

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Causes of pain abdomen in a patient with Crohn's disease include - Inflammatory stricture - Fibrotic stricture - Perforation - Intraabdominal abscess Again these patients have higher risk for renal stone Please describe the pain, it's location and nature Before starting any therapy you need to find out the location of the disease i.e. small intestine, colon or both and what is the type of disease and activity. So, you will need a colonoscopy, a CT enterography and if having UGI symptoms, then an UGIscopy. After all these can plan therapy for the patient, whether budesonide or prednisolone or azathioprine or biological or surgery

K/C/O Crohn's disease presented to pain is due to.... 1) Acute exacerbation of symptoms. 2) Perforation. 3) Infection/Abscess. 4) Obstruction due to stenosis at Ileocecal region . In your case X-ray abdomen is normal. Do CECT abdomen to rule out Complications of Crohn's or other organ pathology. Start with Steroids, Metronidazole and continuation of 5 ASA.

It is difficult to suspect diagnosis of Crohns from plain xray abdomen. If there Is Perforation, plain abdominal erect posture will show gas under diaphragm . Barium meal follow through, capsule enteroscopy with biopsy will be required to confirm Chrohns. Sometimes laparotomy for intestinal obstruction or perforation confirms Crohns .

Crown's disease Needs further investigation and evaluation to conclude and line of treatment. Rule out any eventuality. Continue treatment with diet control and change in life style. Change medicine as per reports.

Thanks Dr Dinesh Gupta
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Possible flare of the disease or may be an infection, which is causing mucosal oedema of the ascending and transverse colon.treatment would require steroids+antibiotics.

X-RAY STUDY.. NAD.. NEED'S..CLINICOPATHOLOGICAL EVALUATION WITH.. HEMOGRAM.. CRP.. LFT.. COLONOSCOPY..SIGMOIDOSCOPY..OR.. CAPSULE ENDOSCOPY..

Tnx Dr Vipin Bihari Jain
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SUGGESTIVE OF MILDLY. DILATED... ...LARGE. INTESTINE MILD INTESTINAL. OBSTRUCTION NEEDS. FURTHER. EVALUATION

Large bowel mild dilated collapsed small bowel may be mild intestinal obstruction Bariun and CT abdomen

It's normal X ray abdomen Prominent gas shadows in colon is seen, however it is normal physiological variation

Ulcerative colitis with loss of haustra of descending colon most probably. Experts opinion needed

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