Acute jejunoileal obstruction due to a pseudopolyp in a child with undiagnosed crohn disease: a case report.

Efstratios Christianakis,Michael Pitiakoudis,Spiros Rizos,Nikolaos Pashalidis,Evangelos Mplevrakis,Maria Chorti,Dimitrios Filippou,Stavroula Kokkinou

doi:10.1186/1752-1947-2-54

Abstract

IntroductionCrohn's disease (CD) can affect any part of the alimentary tract from the mouth to the anus, with most common site being the terminal ileum.Case presentationA child suffering from undiagnosed Crohn disease (CD), presented with an acute abdominal obstruction due to a large pseudopolyp in the jejunoileal area. At laparotomy, a jejunoileal segment of 45 cm, containing multiple areas of damage to the small intestine, was excised and a primary end – to – end anastomosis was performed.ConclusionThe coexistence of an intestinal pseudopolyp with undiagnosed Crohn's disease may be the cause of acute abdominal obstruction in children.

Highlights

Crohn's disease (CD) can affect any part of the alimentary tract from the mouth to the anus, with most common site being the terminal ileum.Case presentation: A child suffering from undiagnosed Crohn disease (CD), presented with an acute abdominal obstruction due to a large pseudopolyp in the jejunoileal area
Intestinal obstruction due to a large pseudopolyp is a rare event in CD [1,2]
CD can affect any part of the alimentary tract from the mouth to the anus, with the most common site being the terminal ileum [1,2]

Summary

Introduction

Crohn's disease (CD) can affect any part of the alimentary tract from the mouth to the anus, with most common site being the terminal ileum. A 12-year-old boy was brought to the emergency department with acute abdominal pain lasting 12 hours, and associated abdominal distension, absolute constipation for two days, vomiting and fever of 38.5°C. When examined he had general abdominal tenderness. The damage included macroscopically a rigid and thickened mass in the ileal portion, creeping fat, multiple granulomas in the external intestinal surface and ulcers, two of which had parietal ruptures with fluid escape. A resection of 45 cm of the ileo-jejunal portion, including all areas of intestinal damage, was performed and a primary end to end ileo-jejunal anastomosis completed the operation (Figure 2). A characteristic large pseudopolyp, 4 cm in diameter, was in the obstructed portion of the mass

Discussion

Findings

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