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.com
Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Bariatric Surgery 2018 & Gastro 2018
March 15-16, 2018
JOINT EVENT
12
th
Global Gastroenterologists Meeting
3
rd
International Conference on Metabolic and Bariatric Surgery
&
March 15-16, 2018 Barcelona, Spain
A 35-year-old patient with abdominal pain, mesenteric lymphadenopathy and Sweet’s syndrome: An
atypical presentation of Crohn’s disease
Maria Birnie
Cumberland Infirmary, UK
C
rohn’s disease is a form of inflammatory bowel disease that typically presents with abdominal pain, weight loss and bloody
diarrhoea. Sweet’s syndrome is a neutrophilic dermatosis which presents with erythematous papules and is associated
with Crohn’s disease amongst other conditions. We present an unusual case of a 35-year old lady with Crohn’s disease where
abdominal pain, extensive mesenteric lymphadenopathy and Sweet’s syndrome were the initial presenting features. We describe
how diagnostic uncertainty led to extensive investigations and recurrent admissions. Initially the patient was treated as having
Yersinia infection due to suggestive histology although serology was negative. Yersinia infection, gastrointestinal tuberculosis
and Crohn’s disease may have similar radiological and histological appearances so differentiation can be difficult. We discuss
the impact of delayed diagnosis (17 months) and share some interesting points on the difficulties of diagnosing Crohn’s disease
on mesenteric lymph node histology alone, especially when macroscopic examination of the bowel wall is normal. Treatment
for Crohn’s disease resulted in improvement of her symptoms and return to work.
maria.birnie@doctors.org.ukJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C1-065