Vallejo Charles, Gheit Yousra, Nagi Talwinder K, Suarez Zoilo K, Haider Muhammad, Zahra Touqir
Internal Medicine, Florida Atlantic University, Boca Raton, USA.
Internal Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Cureus. 2024 Jan 29;16(1):e53151. doi: 10.7759/cureus.53151. eCollection 2024 Jan.
Crohn's disease is an inflammatory bowel disease that has a bimodal distribution, occurring most frequently between ages 15 to 30 years and 40 to 60 years. It presents with a relapsing and remitting course. The most common area involved is the terminal ileum and right colon and the inflammation oftentimes leads to non-caseating granulomas and ulcerations in both the superficial mucosa and deeper layers. Additionally, pneumatosis intestinalis is defined as the presence of gas and free air in the extraluminal space of the intestines which is an abnormal occurrence and correlates with underlying pathology. There are only a few cases reported in the literature that present pneumatosis intestinalis in the setting of, and possibly linked to, Crohn's disease. Our case presents an elderly male patient with jejunal ulcerations and strictures suggesting Crohn's disease and associated pneumatosis intestinalis as evidenced on outpatient computed tomography (CT) enterography. Upon presentation to the hospital, the patient was non-toxic and was not complaining of any pain. During his inpatient stay, there was a suspicion of Crohn's disease and therefore he was started on Infliximab therapy. We will review the possible pathogenesis of Crohn's disease and other cases presenting pneumatosis intestinalis in the setting of Crohn's disease.
克罗恩病是一种炎症性肠病，具有双峰分布，最常发生在15至30岁以及40至60岁之间。它呈复发和缓解病程。最常受累的部位是回肠末端和右结肠，炎症常常导致浅表黏膜和深层出现非干酪样肉芽肿及溃疡。此外，肠壁积气被定义为肠道腔外间隙存在气体和游离气体，这是一种异常情况，与潜在病理相关。文献中仅有少数病例报道在克罗恩病背景下出现肠壁积气，且可能与之相关。我们的病例报告了一名老年男性患者，其空肠存在溃疡和狭窄，提示克罗恩病，并伴有肠壁积气，门诊计算机断层扫描（CT）小肠造影证实了这一点。患者入院时无中毒症状，也未诉任何疼痛。在其住院期间，怀疑患有克罗恩病，因此开始使用英夫利昔单抗治疗。我们将回顾克罗恩病可能的发病机制以及其他在克罗恩病背景下出现肠壁积气的病例。
