diagnose?? patient complains of pain and distension all over the abdomen since 1 month known diabetic on medication history of chronic smoking

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Cholelithiasis with Sub Acute intestinal obstruction.. As per the CT report indicative of crohn's disease but Abdominal koch's cannot be ruled out. A colonoscopy with biopsy to confirm crohn's disease. Treatment of crohn's disease is generally symptomatic. Surgery is only reserved for selected patients

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Calculus Gall bladder and subacute Intestinal obtruction may be due to chrohan's disease abdomen.

Though the CT findings are suggestive of Crohn's disease still it needs to be differentiated from IC Koch's. Colonoscopy and biopsy will aid in this regard and if required an image guided interloop fluid can be tested via GeneXpert for MTB presence. ESR and CRP would be raised in both, so not helpful. As far as SAIO is concerned, the treatment depends upon the clinical picture whether obstipation is present or not.

Do OGD and Colonoscopy for confirmation of? Kochs? IBD

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If Intestinal obstruction is relived by conservative management then go for colonoscopy and biopsy and symptomatic treatment.GB stone can be managed later if patient is symptomless at present and if not relieved then laparotomy and management of GB stone

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Crohn’s disease should be second possibility in India as ileocecal TB should be first Colonoscopy & biopsy Treat accordingly.

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Intestinal obstruction could be due to ileocaecal cochs

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Koch's Abdomen, with SAIO with cholelithiasis. In view of CT result, biopsy from the rectal wall must be done to exclude Crohn's disease.

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Cholilithiasis with mild illitis

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