Crohn vs radiation enteritis - Forum

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John Dissector

Crohn vs radiation enteritis - Ärzteforum

Post#1 »

Interesting 41 yo female who originally presented in July with question of appendicitis. I did not feel she had appendicitis at that time and got a history of a radical hysterectomy with post op RT performed in 2008 for cervical ca. A CT scan showed dilated matted loops of SB in the RLQ. She was seen by the gastroenterologist who performed a colonoscopy through to the terminal ileum and biopsies came back consistent with Crohns disease. This was an obvious surprise since we had expected only radiation enteritis. Her rectum had a non specific chronic inflammation and the rest of her colon was clean. She was treated with steroids and rapidly improved. I next saw her in July of 2014 when she presented with the identical picture of RLQ pain of sudden onset, WBC 15,000, temp 38. Admitted and CT showed no change. She felt better in a day or so and refused any further workup or therapy. Did well for 7 months and presented the other day with similar complaints and findings though the pain is still present but less so. No real peritoneal findings. CT the same. UGI with SBFT shows a mid ileal 15 cm strictured segment and another 20 cm stricture about 60 cm from the ileocecal valve. I suspect these are radiation strictures and wonder if she ever had Crohns. If she agrees I plan on resecting the segments. Any thoughts?

John Dissector

Re: Crohn vs radiation enteritis - Ärzteforum

Post#2 »

She had no eivdence of Crohns and about two feet of lead pipe SB in the pelvis. I resected and she has done well.

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