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青少年外阴克罗恩病,经手术治疗失败后确诊。

Vulvar Crohn's disease in an adolescent diagnosed after unsuccessful surgical treatment.

机构信息

Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Institute of Women's Life Science, Yonsei University College of Medicine, Seoul, Korea.

出版信息

BMC Womens Health. 2021 Aug 28;21(1):316. doi: 10.1186/s12905-021-01449-4.

DOI:10.1186/s12905-021-01449-4
PMID:34454474
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8399794/
Abstract

BACKGROUND

This case report presents a case of Vulvar Crohn's disease (VCD) in an adolescent, that is an uncommon manifestation of Crohn's disease (CD) without gastrointestinal symptoms. Before treating CD itself with proper medication, vulvar abscess continued to recur without improvement.

CASE PRESENTATION

We report the case of an 18-year-old woman with VCD. After treatment with azathioprine 50 mg daily and mesalazine 1 g three times daily, vulvar lesions resolved after 6 weeks. We collected electronic medical data on patient characteristics, and evaluated findings of physical examinations, pelvic MRI, and biopsy specimen obtained from gastroduodenoscopy/colonoscopy.

CONCLUSIONS

VCD is a rare manifestation of CD that may be misdiagnosed in the absence of gastrointestinal symptoms leading to delayed treatment. If a patient has an unexplained vulvar inflammatory lesion and with repeated failed surgical treatment, gynecologists should consider the possibility of a VCD.

摘要

背景

本病例报告介绍了一例青少年外阴克罗恩病(VCD),这是一种无胃肠道症状的克罗恩病(CD)的罕见表现。在使用适当药物治疗 CD 本身之前,外阴脓肿持续复发,没有改善。

病例介绍

我们报告了一例 18 岁女性 VCD 病例。在每天使用 50mg 硫唑嘌呤和每天三次 1g 美沙拉嗪治疗后,外阴病变在 6 周后消退。我们收集了患者特征的电子医疗数据,并评估了体格检查、盆腔 MRI 和经胃肠镜/结肠镜获取的活检标本的结果。

结论

VCD 是 CD 的一种罕见表现,如果没有胃肠道症状,可能会导致误诊,从而导致治疗延误。如果患者有不明原因的外阴炎症性病变且反复手术治疗失败,妇科医生应考虑 VCD 的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/f9f3b3333768/12905_2021_1449_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/f3428785b644/12905_2021_1449_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/c98f2c9ee8b5/12905_2021_1449_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/19c14a8d34f9/12905_2021_1449_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/f9f3b3333768/12905_2021_1449_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/f3428785b644/12905_2021_1449_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/c98f2c9ee8b5/12905_2021_1449_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/19c14a8d34f9/12905_2021_1449_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b699/8399794/f9f3b3333768/12905_2021_1449_Fig4_HTML.jpg

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Delayed Diagnosis of Vulvar Crohn's Disease in a Patient with No Gastrointestinal Symptoms.一名无胃肠道症状患者的外阴克罗恩病延迟诊断
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Crohn's disease of the vulva: A prospective study.外阴克罗恩病:一项前瞻性研究。
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A Decade of Waiting: Experiences of Women Living With Vulvar Crohn's Disease and Interactions With Healthcare Professionals Related to Their Sexual Well-Being: A Qualitative Study.十年等待:外阴克罗恩病女性的经历及其与医疗保健专业人员在性健康方面的互动:一项定性研究
Crohns Colitis 360. 2023 May 12;5(3):otad025. doi: 10.1093/crocol/otad025. eCollection 2023 Jul.
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On a Knife's Edge: Management of Vulvar Cutaneous Crohn's Disease.处于刀刃之上:外阴皮肤克罗恩病的管理
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Vulvar metastatic Crohn disease: clinical, histopathological and ultrasonographic findings.外阴转移性克罗恩病:临床、组织病理学及超声检查结果
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