«Quiz des Monats»
Juli 2001
   
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Case study:
Question: A 32-year-old man presents to the hospital with vomiting and abdominal pain. He has had a 7 years history of Crohn"s disease which has been difficult to control. On physical examination he has pyrexia(38.2°C) and there is a marked right lower quadrant tenderness. His WBC is 16600 with left shift. The abdominal CT shows a 4 cm abscess arising from the terminal ileum.
 
Which of the following statements is true regarding this patient?
1. Surgery should be avoided at all costs.

 
2. There is evidence that mesalamine, high-dose metronidazole, or azathioprine/ 6-mercaptopurine started shortly after surgery can reduce postoperative recurrence.

 
3. He should be treated with high dose steroids.

 
4. This patient is expieriencing an unusual complication of Crohn's disease.

 
5. Surgery that removes the abscess and the diseased segment of the bowel has strong probability of being curative.

 

 

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