Cirugía General, Hospital Universitario Miguel Servet, Spain.
Cirugía General , Hospital Universitario Miguel Servet, España.
Rev Esp Enferm Dig. 2023 Dec;115(12):733-734. doi: 10.17235/reed.2023.9521/2023.
We present the case of a 34-year-old man with daily vomiting and 20% weight loss in a year. A gastroduodenoscopy was performed, noticing 2nd and 3rd duodenal portion dilatation and inflammatory involvement of the 3rd and 4th portion, causing luminal stenosis. These findings are the same than in the magnetic resonance . The biopsy proves the histological diagnosis of Crohn's disease. At the beginning the patient was treated with Prednisone, Adalimumab and Ustekinumab. After 9 months, surgery was decided because the disease was refractory to treatment and there was corticosteroid dependence. A partial resection of 3rd and 4th portion of the duodenum and the first loop of jejunum was performed, with duodenojejunal anastomosis. The patient presents good postoperative evolution and after 1 year he remained asymptomatic under treatment with Ustekinumab.
我们报告了一例 34 岁男性患者，其每日呕吐并在一年内体重减轻了 20%。进行了胃镜检查，注意到第 2 和第 3 十二指肠段扩张以及第 3 和第 4 部分的炎症累及，导致管腔狭窄。这些发现与磁共振成像相同。活检证实了克罗恩病的组织学诊断。起初，患者接受了泼尼松龙、阿达木单抗和乌司奴单抗治疗。9 个月后，由于疾病对治疗有抗药性且存在皮质类固醇依赖性，决定进行手术。进行了第 3 和第 4 部分十二指肠和第 1 段空肠的部分切除术，并进行了十二指肠空肠吻合术。患者术后恢复良好，在使用乌司奴单抗治疗 1 年后仍无症状。
