A 26- year- old woman was admitted for the investigation of abdominal sympt oms related to ileal Crohn’ s disease. The patient had been diagnosed 3 years p reviously with systemic sclerosis, and had been experiencing...A 26- year- old woman was admitted for the investigation of abdominal sympt oms related to ileal Crohn’ s disease. The patient had been diagnosed 3 years p reviously with systemic sclerosis, and had been experiencing digestive complaint s for 6 months. A first computed tomography (CT) scan showed ileal intestinal mucosal alterations, associated with a scle rolipomatosis and suspicion of ileal stenosis. An ileocolonoscopy was then perfo rmed and showed ulcers in the terminal ileum with nonspecific inflammatory chang es found on biopsies, both suggesting the diagnosis of Crohn’ s disease. The pa tient was admitted for M2A capsule endoscopy, in order to clarify the respective roles of systemic sclerosis and Crohn’ s disease with regard to the symptoms a nd secondarily to determine the anatomical extent of the Crohn’ s lesions. A pa tency capsule was administered, for detection of intestinal stenosis before caps ule endoscopy was done. At 30 hours after capsule ingestion, the patient complai ned of abdominal pain and nausea and experienced intestinal obstruction due to t he blockage of the patency capsule in the ileal stenosis. The capsule dissolved after 76 hours and the patient then improved. After a few days, the patient unde rwent ileocecal resection. Pathological examination of the surgical specimen con firmed the presence of an ileal stenosis 17 cm in length. In some circumstances a patency capsule may dissolve slowly, leading to transitory intestinal obstruct ion requiring medical intervention. It should thus be used cautiously under clin ical surveillance in patients with Crohn’ s disease.展开更多
文摘A 26- year- old woman was admitted for the investigation of abdominal sympt oms related to ileal Crohn’ s disease. The patient had been diagnosed 3 years p reviously with systemic sclerosis, and had been experiencing digestive complaint s for 6 months. A first computed tomography (CT) scan showed ileal intestinal mucosal alterations, associated with a scle rolipomatosis and suspicion of ileal stenosis. An ileocolonoscopy was then perfo rmed and showed ulcers in the terminal ileum with nonspecific inflammatory chang es found on biopsies, both suggesting the diagnosis of Crohn’ s disease. The pa tient was admitted for M2A capsule endoscopy, in order to clarify the respective roles of systemic sclerosis and Crohn’ s disease with regard to the symptoms a nd secondarily to determine the anatomical extent of the Crohn’ s lesions. A pa tency capsule was administered, for detection of intestinal stenosis before caps ule endoscopy was done. At 30 hours after capsule ingestion, the patient complai ned of abdominal pain and nausea and experienced intestinal obstruction due to t he blockage of the patency capsule in the ileal stenosis. The capsule dissolved after 76 hours and the patient then improved. After a few days, the patient unde rwent ileocecal resection. Pathological examination of the surgical specimen con firmed the presence of an ileal stenosis 17 cm in length. In some circumstances a patency capsule may dissolve slowly, leading to transitory intestinal obstruct ion requiring medical intervention. It should thus be used cautiously under clin ical surveillance in patients with Crohn’ s disease.
