In: Crohn's disease18 Aug 2012
A 29-year-old man was first seen in 1994 with increasing abdominal pain, weight loss and vomiting. The previous history was significant in that in 1991 he presented at the Cranbrook Regional Hospital in British Columbia with a perforation of the terminal ileum, secondary to Crohn’s disease, of which he was previously unaware. At that time he had a right hemicolectomy and recovered uneventfully. When seen in 1994, investigation revealed a partial small bowel obstruction and hospitalization was necessary. He was treated with intravenous corticosteroids and nasogastric suction, but his bowel obstruction did not resolve.
A resection of the neoterminal ileum was then performed. Surgical pathology revealed Crohn’s disease of the neoterminal ileum and the right colon. His postoperative course was marred by intraabdominal bleeding. The patient had to be returned to the operating room where the anastomosis was found to be ruptured and he required a reconstruction and reanastomosis. No further problem was encountered and he was discharged.
In late 1994 he was seen because of persistent lower abdominal cramps and passage of bright red blood in his stools. He had lost much time from work and could not carry on because of weakness, diarrhea and fatigue. He had had multiple transfusions of blood. His hemoglobin remained between 80 g/L and 100 g/L throughout the six months that he was seen. Cheapest online shopping – find Purchase Zyrtec at best fully-licensed pharmacy.
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