Fulminant primary manifestation of Crohn's colitis "Hot Crohn's disease".
Following the very short course of a disease with watery diarrhea, fever, nausea, meteorism and a severe feeling of general illness, a 22-year-old patient was diagnosed as having a toxic megacolon, and a subtotal colectomy was carried out. The postoperative progression was uncomplicated and the patient recovered quickly. The examination of the operation specimen revealed a serious ulcerous colitis with relative omission of the rectum and the distal sigmoid colon. After critical evaluation of the histological findings, it was judged to be a fulminant Crohn's colitis and, for the purposes of differential diagnosis, differentiated from ulcerative colitis and colitis indeterminate. The formal pathogenesis of the inflammatory-ulcerous processes is discussed, in particular with regard to the activation of the macrophages and the very short anamnesis in a clinically established primary manifestation of the disease.
Heise
W
W
Department of Internal Medicine, Auguste-Viktoria-Hospital Berlin-Schöneberg.
Kersten
O
O
Kassner
K M
KM
Birkenmeyer
G
G
Grosse
G
G
Niedobitek
F
F
D000328:Adult; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000473:pathology / Q000601:surgery; D003106:Colon / Q000473:pathology; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008532:Megacolon, Toxic / Q000473:pathology / Q000601:surgery*