Crohns Disease Manifesting as a Duodenal Obstruction: An Unusual Case

Abstract

We describe a case of a 31-year-old man who presented with a 3-year history of worsening upper abdominal pain, nausea, and vomiting: symptoms that were resistant to medical treatment and unexplained despite a thorough diagnostic evaluation. Then, an upper gastrointestinal series with small bowel follow-through showed proximal duodenal dilation and distal decompression of the duodenum, suggestive of a partial duodenal obstruction. An abdominal computed tomography (CT) scan revealed a transition point in the distal duodenum. At surgery, a segmental resection of the distal duodenum with a duodenojejunal anastomosis was performed. Histopathologic examination of the specimen revealed Crohns disease. Therefore, making the diagnosis of duodenal obstruction has significant clinical implications and, in the setting of Crohns disease, is evidence of an underlying intestinal stricture, stenotic area, or adhesion.




Gastroenterol Res. 2018;11(6):436-440
doi: https://doi.org/10.14740/gr1105