ABSTRACT
BACKGROUND/AIMS: Crohn's disease is a chronic inflammatory bowel disease. Stricture is a very important indication for surgical intervention as strictures can lead to intestinal obstruction. Strictures can be divided into inflammatory and fibrous strictures. Intestinal obstruction due to inflammatory stricture is expected to be resolved with medical treatment. However, factors that can predict the response to medical treatments are unknown. In the present study, we aimed to identify the factors that can predict the response to medical treatments in Crohn's disease patients with intestinal obstruction. METHODS: Data were collected by retrospectively reviewing the medical records of patients with Crohn's disease who visited the emergency department at Samsung Medical Center in Seoul from January 1, 2000 to December 31, 2010 because of intestinal obstruction. Based on the response to medical treatments, we classified the patients as responders and non-responders and compared the clinical, biochemical, and radiological findings of the two groups. RESULTS: A total of 39 patients were enrolled. Twenty-nine patients responded to medical treatments whereas 10 patients did not. Significant differences were observed between the two groups in terms of vomiting and duration of disease before the development of obstruction. CONCLUSIONS: Patients who responded to the medical treatments exhibited a higher incidence of vomiting and longer duration of disease before the development of obstruction. However, further prospective studies are needed to identify the factors that can predict the response to medical treatments.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , C-Reactive Protein/analysis , Crohn Disease/complications , Follow-Up Studies , Intestinal Obstruction/etiology , Leukocytes/cytology , Retrospective Studies , Risk Factors , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
We report a case of a 63-year-old man with adult respiratory distress syndrome and pulmonary infarction. The patient presented with fever, dyspnea, pleuritic chest pain, and acute respiratory failure, and we applied mechanical ventilation and steroid therapy. Pulmonary infarction and diffuse alveolar damage were confirmed by open-lung biopsy. Diffuse alveolar damage activated the blood coagulation system, resulting in thrombosis in the pulmonary vasculature. After anticoagulation therapy, the patient improved rapidly. We report a rare pulmonary infarction caused by diffuse alveolar damage confirmed by open-lung biopsy.
Subject(s)
Humans , Middle Aged , Biopsy , Blood Coagulation , Chest Pain , Dyspnea , Fever , Pulmonary Infarction , Respiration, Artificial , Respiratory Distress Syndrome , Respiratory Insufficiency , ThrombosisABSTRACT
We report a case of a 63-year-old man with adult respiratory distress syndrome and pulmonary infarction. The patient presented with fever, dyspnea, pleuritic chest pain, and acute respiratory failure, and we applied mechanical ventilation and steroid therapy. Pulmonary infarction and diffuse alveolar damage were confirmed by open-lung biopsy. Diffuse alveolar damage activated the blood coagulation system, resulting in thrombosis in the pulmonary vasculature. After anticoagulation therapy, the patient improved rapidly. We report a rare pulmonary infarction caused by diffuse alveolar damage confirmed by open-lung biopsy.