Quintana C, Galleguillos L, Benavides E, Quintana J C, Zúñiga A, Duarte I, Klaassen J, Kolbach M, Soto R M, Iacobelli S, Alvarez M, O'Brien A
Facultad de Medicina, Pontificia Universidad Catolica de Chile, 8330024 Santiago, Chile ; Facultad de Medicina, Universidad de los Andes, 7620001 Santiago, Chile.
ISRN Gastroenterol. 2012;2012:285475. doi: 10.5402/2012/285475. Epub 2012 Nov 19.
Determining the diagnosis of Crohn's disease has been highly difficult mainly during the first years of this study carried out at the Pontificia Universidad Catolica (PUC) Clinical Hospital. For instance, it has been frequently confused with Irritable bowel syndrome and sometimes misdiagnosed as ulcerative colitis, infectious colitis or enterocolitis, intestinal lymphoma, or coeliac disease. Consequently, it seems advisable to characterize what the most relevant clinical features are, in order to establish a clear concept of Crohn's disease. This difficulty may still be a problem at other medical centers in developing countries. Thus, sharing this information may contribute to a better understanding of this disease. Based on the clinical experience gained between 1963 and 2004 and reported herein, the main clinical characteristics of the disease are long-lasting day and night abdominal pain, which becomes more intense after eating and diarrhoea, sometimes associated to a mass in the abdomen, anal lesions, and other additional digestive and nondigestive clinical features. Nevertheless, the main aim of this work has been the following: is it possible to make, in an early stage, the diagnosis of Crohn's disease with a high degree of certainty exclusively with clinical data?
在 Pontificia Universidad Catolica（PUC）临床医院开展的这项研究的最初几年里，确定克罗恩病的诊断一直非常困难。例如，它经常与肠易激综合征混淆，有时还会被误诊为溃疡性结肠炎、感染性结肠炎或小肠结肠炎、肠道淋巴瘤或乳糜泻。因此，为了明确克罗恩病的概念，确定最相关的临床特征似乎是可取的。在发展中国家的其他医疗中心，这种困难可能仍然是个问题。因此，分享这些信息可能有助于更好地了解这种疾病。基于本文报道的 1963 年至 2004 年间获得的临床经验，该疾病的主要临床特征是持续性的昼夜腹痛，进食后疼痛加剧，伴有腹泻，有时伴有腹部肿块、肛门病变以及其他额外的消化和非消化临床特征。然而，这项工作的主要目的如下：仅凭借临床数据，能否在早期就高度确定地诊断出克罗恩病？
