Article Sidebar

Download
PDF

Main Article Content

Abstract

ABSTRACT
The chronic and lifelong gastrointestinal tract disorder of Crohn’s Disease (CD) is a type of inflammatory bowel disease with unclear causative agent. CD is directly correlated with a triad group of predisposing factors including genetic problems, immune system malfunctions and environmental factors. Though it is uncommon in Africa yet we come across this entity sparingly. The signs and symptoms of CD overlap with many other abdominal disorders like tuberculosis, ulcerative colitis, irritable bowel syndrome etc. It may even involve systems other than GIT.Although it is difficult to make an accurate diagnosis of this disease, many diagnostic armamentaria are available to suggest its presence. Most of the patients are treated conservatively yet a few may require surgical intervention especially presenting with complications like intestinal obstruction, perforations, abscess and fistula formations.We have encountered one such case of intestinal obstruction requiring surgical intervention which was confirmed to be CD histopathologically. Rarity and clinical curiosity of this entity suggest reporting of this case.
RÉSUMÉ
Le trouble de l’appareil gastro-intestinal chronique et persistant de la maladie de Crohn (MC) est un type de maladie inflammatoire de l’intestin sans cause évidente. La MC est directement corrélée à une triade de facteurs prédisposants, notamment des problèmes génétiques, des dysfonctionnements du système immunitaire et des facteurs environnementaux. Les signes et les symptômes de la MC se chevauchent avec de nombreux autres troubles abdominaux tels que la tuberculose, la colite ulcéreuse, le syndrome du côlon irritable, etc. Ils peuvent même concerner des systèmes autres que le système digestif. Bien qu’il soit difficile de poser un diagnostic précis de cette maladie, de nombreux signes peuvent la suggérer. La plupart des patients sont traités de façon conservatrice, mais quelques-uns peuvent nécessiter une intervention chirurgicale, en particulier lors des complications telles qu'une obstruction intestinale, des perforations, un abcès et des fistules. Nous avons rencontré un cas d'obstruction intestinale nécessitant une intervention chirurgicale confirmée histopathologiquement comme une MC. La rareté et la curiosité clinique de cette entité suggèrent de signaler ce cas.

Keywords

Crohn’s disease Autoimmune disorder Granulomatous colitis Regional enteritis

Article Details

How to Cite
Josep Bamidele Johnson, A. (2019). Crohn’s Disease in a Developing African Mission Hospital: a Rare Case Report. HEALTH SCIENCES AND DISEASE, 20(2). https://doi.org/10.5281/hsd.v20i2.1372
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Iacobuzio-Donahue, C.A. & Montgomery, E.A. (2012). Idiopathic inflammatory bowel disease. In J.R. Goldblum (series editor), Gastrointestinal and Liver Pathology. USA: Elsevier Saunders
  2. Dalziel, T.K. Chronic interstitial enteritis. Br Med J, 1913; ii: 1068
  3. Lockhart-Mummery, H.E. & Morson, B.C. Crohn’s disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut. 1960;1: 87
  4. Morson, B.C. & Lockhart-Mummery, H.E. Anal lesions in Crohn’s disease. Lancet 1959; ii:1122
  5. Fielding, J.F., Toye, D.K., Beton, D.K. & Cooke, W.T. Crohn’s disease of the stomach and duodenum. Gut. 1970;11:1001
  6. Basu, M.K., Asquith, P., Thompson, R.A. & Cooke, W.T. Proceedings: Oral lesions in patients with Crohn’s disease. Gut. 1974; 15: 346
  7. Huchzermeyer, H., Paul, F., Seifert, E., Frohlich, H. & Rasmussen, C.W. Endoscopic results in five patients with Crohn’s disease of the esophagus. Endoscopy 1977; 8: 75
  8. Rankin, G.B., Watts, H.D., Melnyk, C.S. & Kelley, M.L. Jr. National Cooperative Crohn’s Disease Study: extraintestinal manifestations of perianal complications. Gastroenterology 1979; 77: 914
  9. Greenstein, A.J., Sachar, D.B., Smith, H., Janowitz, H.D. & Aufses, A.H. Jr. Patterns of neoplasia in Crohn’s disease and ulcerative colitis. Cancer 1980; 46:403
  10. Cho K.J, Suh Y.L, Kim CW, Chi J.G Journal of Korean Medical Sciences 1987; 2(2): 133-136
  11. Logan I. Bowlus CL. The geoepidemiology of autoimmune intestinal disease. Autoimmune Rev. 2013: 9(5): A372-A378
  12. Cosnes J, Gower–Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology 2011:140:1785-1794
  13. Economou M, Zambeli E, Michopoulos S. Incidence and prevalence of Crohn’s disease and its etiological influence. Annals of gastroenterology 2009:22(3): 58-67
  14. Hanauer SB, Sandborn W. Management of Crohn's Disease in Adults. The Am J Gastroenterol. 2001; 96(3):635–643.
  15. Sathiyasekaran M, Shivbalan S. Crohn's Disease. Indian J Pediatr. 2006; 73(8):723–729. [PubMed: 16936369]
  16. Ouyang Q, Tandon R, Goh K-L,et al.The emergence of inflammatory bowel disease in the Asian Pacific region. Curr Opin Gastroenterol 2005; 21:408–13.
  17. Wright JP, Froggatt J, O’Keefe EA, et al. The epidemiology of inflammatory bowel disease in Cape Town 1980–1984.S Afr Med J1996; 70: 10–5.
  18. Lakatos PL. Recent trends in the epidemiology of inflammatory bowel disease: up or down. World J Gastroenterol 2006; 14: 6102–8.
  19. Epstein D, Watermeyer G, Kirsch R. Review article: the diagnosis and management of Crohn’s disease in populations with high-risk rates for tuberculosis Aliment Pharmacol Ther25, 1373–1388
  20. Steury EM, Templeton AC. Crohn's disease in Africa. A case report and review Trop Geogr Med. 1980 Jun; 32(2):172-3
  21. Nguyen, G.C., Torres, E.A., Regueiro, M. et al. Inflammatory bowel disease characteristics among African-Americans, Hispanics, and Non-Hispanic Whites: characterization of a large North American cohort. Am J Gastroenterol. 2006; 101: 1012–1023
  22. Mulhall AM, Gholson RD, Eichenberger MR, Galandiuk S. Inflammatory bowel disease and African Americans: a systematic review. Inflamm Bowel Dis 2008 Jul; 14(7):960-967.
  23. Behzadi P, Behzadi E, Ranjbar R. The Incidence and Prevalence of Crohn’s Disease in Global Scale. SOJ Immunology 2015; 3(2): 1-6
  24. Platell C, Mackay J, Collopy B, et al. Anal pathology in patients with Crohn's disease. Aust N Z J Surg. 1996; 66:5–9. [PubMed: 8629983]
  25. Thompson NP, Wakefield AJ, Pounder RE. Prognosis and prognostic factors in inflammatory bowel disease. The Saudi J Gastroentrol. 1995; 1(3):129–137.
  26. Freeman HJ. Use of the Crohn's disease activity index in clinical trials of biological agents. World J Gastroenterol. 2008; 14(26):4127–4130. [PMCID: PMC2725371] [PubMed: 18636655]
  27. Stange EF, Travis SP, Vermeire S, et al. European evidence based consensus on the diagnosis and management of Crohn's disease: definitions and diagnosis. Gut. 2006; 55:1–15. [PMCID: PMC1859998] [PubMed: 16481628]
  28. Katsanos KH, Tsianos VE, Maliouki M, et al. Obstruction and pseudo-obstruction in inflammatory bowel disease ; 23(4): 243-256. Ann gastroenterol. 2010; 23(4):243–256.