[Incarcerated Spieghel-Hernie mimicking an acute exacerbation of Crohn's disease].
We report on a 25-year-old woman with long-standing Crohn's disease. Upon admittance to the emergency department, the patient complained of abdominal pain with increasing intensity over the last few days. Clinical examination revealed an abdominal mass in the right lower quadrant, and blood tests showed elevated markers of inflammation. Surprisingly, abdominal ultrasound did not show the suspected complication of Crohn's disease, but rather an incarcerated abdominal wall hernia, which turned out to be a spigelian hernia upon surgical repair. This case stresses the importance of abdominal ultrasound to rule out other diagnoses in patients with chronic inflammatory bowel disease in the emergency setting before starting a potentially dangerous treatment with high-dose steroids.
Bachmann
O
O
Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover. bachmann.oliver@mh-hannover.de
Baus
S
S
Hoffmann
M W
MW
Manns
M P
MP
Gebel
M
M
D000005:Abdomen / Q000000981:diagnostic imaging*; D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D003422:Critical Care / Q000379:methods*; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D012720:Severity of Illness Index; D014463:Ultrasonography