The incidence of Crohn disease has gradually increased in recent years. The diagnosis and treatment of Crohn disease has gained more and more attention from clinicians. This article is to propose solutions to problems in the diagnosis and treatment of Crohn disease, based on evidence from clinical trials, including the diagnosis, differential diagnosis, management of steroid-refractory disease and anal fistula, and timing of surgery.
Crohn Disease ; diagnosis ; therapy ; Humans

Intraabdominal abscesses and their sequalae have long been observed in patients with Crohn's disease. Patients with Crohn's disease account for little more than 0.5% of all patients coming to laparotomy for intraabdominal abscess. However, an intraabdceninal abscess will develop as a complication of Crohn's disease in 12 to 25% of patients. For enteroparietal abscess, incision and drainage with later definitive resection is the optimal therapy, However, primary en bloc resection is performed with excellent results recently. We experienced a case of Crohn's disease whose initial problem was intraabdorninal abscess. After surgery, we confirmed Crohn's disease.
Abscess* ; Crohn Disease* ; Diagnosis* ; Drainage ; Humans ; Laparotomy

Crohn's disease (CD) is a nonspecific chronic intestinal inflammatory disease with unknown etiology. The course of CD is persistent and recurrent. In the progress, CD can come with many complications such as obstruction, fistula formation, perforation, and hemorrhage. The early diagnosis, treatment, and the time of the surgery for CD pose a big controversy and challenge. There was a female patient diagnosed as Crohn's disease with severe complication in department of Gastroenterology of the Third Xiangya Hospital, Central South University.  We reported the diagnosis and treatment on this patient. The choice for the medicine and surgury was discussed.
Crohn Disease ; complications ; diagnosis ; therapy ; Female ; Humans

Crohn's disease is a rare inflammatory bowel disease requiring a differential diagnosis with intestinal tuberculosis in Korea. There have been several problems in the diagnosis of Crohn's disease due to the much higher incidcnce of intestinal tuberculosis and the clinical similarities between the two diseases. Therefore, in many cases, treatment involveed anti-Tb drugs based upon empirical diagnosis, This study presents a case of Crohn's disease treated with anti-Tb drugs for about 9 months after intestinal tuberculosis was misdiagnosed.
Crohn Disease* ; Diagnosis ; Diagnosis, Differential ; Inflammatory Bowel Diseases ; Korea ; Tuberculosis*

Colon cancer is the most serious intestinal complication in patients with Crohn's disease. Although an association between Crohn's disease and colon cancer has not been clearly defined, a number of studies in western countries reported an increased rate of colon cancer in patients with Crohn's disease. In Korea, Crohn's disease is rare when compared to western countries, and only a single case of colon cancer associated with Crohn's disease has been reported. We recently experienced a 66-year-old women with colon cancer associated with Crohn's disease.
Aged ; Colonic Neoplasms/complications/*diagnosis ; Crohn Disease/*complications ; Female ; Humans

PURPOSE: We aimed to investigate the efficacy and safety of adalimumab in pediatric-onset Crohn's disease patients who had failed treatment with infliximab. METHODS: In this retrospective study, patients included were those who had been diagnosed with Crohn's disease before 18 years old, and had received treatment with adalimumab after infliximab failure. The efficacy of adalimumab treatment was investigated at 1 month and 1 year, and adverse events that had occurred during treatment with adalimumab were explored. RESULTS: Ten patients were included in this study. The median duration from diagnosis to adalimumab treatment was 5.5 years (range: 2.4-7.9 years). At 1 month after adalimumab initiation, 80% (8/10) of patients showed clinical response, and 40% (4/10) achieved clinical remission. At 1 year, 71% (5/7) of patients showed clinical response, and 43% (3/7) were under clinical remission. Among the total included patients, 5 patients (50%) showed clinical response at 1 year. Primary non-response to adalimumab was observed in 2 patients (20%), and secondary failure to adalimumab was observed in 3 patients (30%) during 1 year treatment with adalimumab. No serious adverse event had occurred during adalimumab treatment. CONCLUSION: Adalimumab was effective for 1 year without serious adverse events in half of pediatric-onset Crohn's disease patients who had failed treatment with infliximab.
Adalimumab* ; Crohn Disease* ; Diagnosis ; Humans ; Infliximab* ; Retrospective Studies

Crohn's disease of the duodenum is a rare disorder that should be considered in patients with distal Crohn's disease in whom significant upper gastrointestinal symytoms develop. A combination of diagnostic tools, including attentive history taking.and appropriate radiographic and endoscopic studies, should be applied to make the diagnosis, Although not always confirmatory, careful histologic study if adequate biopsy material may be helpful. Medical treatment should be the treatment of choice for all patients with nonobstructing Crohn's disease of the duodenum and is similar to that of Crohn's disease elsewhere in the gastrointestinal tract. If obstruction develops, bypass surgery is indicated. We experienced a case of Crohn's disease of the duodenum and reported with the review of the literature.
Biopsy ; Crohn Disease* ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Humans

Crohn's disease of the duodenum is a rare disorder that should be considered in patients with distal Crohn's disease in whom significant upper gastrointestinal symytoms develop. A combination of diagnostic tools, including attentive history taking.and appropriate radiographic and endoscopic studies, should be applied to make the diagnosis, Although not always confirmatory, careful histologic study if adequate biopsy material may be helpful. Medical treatment should be the treatment of choice for all patients with nonobstructing Crohn's disease of the duodenum and is similar to that of Crohn's disease elsewhere in the gastrointestinal tract. If obstruction develops, bypass surgery is indicated. We experienced a case of Crohn's disease of the duodenum and reported with the review of the literature.
Biopsy ; Crohn Disease* ; Diagnosis ; Duodenum* ; Gastrointestinal Tract ; Humans

Crohn Disease ; diagnosis ; drug therapy ; Humans ; Remission Induction

Crohn's disease (CD), one of the major forms of idiopathic inflammatory bowel disease (IBD), is thought to be related to genetic susceptibility coupled with environmental factors. A positive family history is the strongest risk factor for the development of CD. The 10-fold increase in the familial risk of CD strongly suggests that these disorders have a genetic background. The prevalence of IBD in Asian populations is lower than in Western populations, which may be due to genetic influences, environmental factors, or a combination of both. In a Korean study, only 0.25% of parents had IBD in CD probands and all of them had ulcerative colitis. The term of familial CD was used only for those with one or more first-degree relatives with confirmed CD. There are few case reports about familial Crohn's disease in Korea. We report a case of familial CD that the father, the first degree relative was diagnosed as small bowel CD after confirming his son as having CD.
Child ; Colonoscopy ; Crohn Disease/*diagnosis/etiology/radiography ; Family ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Pedigree