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Published byConrad Joplin Modified over 10 years ago
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David J. Hass, MD Assistant Clinical Professor of Medicine Yale University School of Medicine Gastroenterology Center of Connecticut, P.C.
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Case 30 year-old male Recurrent abdominal pain and loose stools WBC 12. Hct 31. CRP 14. Stool studies negative
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Case Appears well, but fatigued. Lungs clear to auscultation, normal cardiac exam Hyperactive bowel sounds, right lower quadrant tenderness and minimal guarding Exam otherwise unremarkable
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Case CT scan revealing for thickened proximal ileal loop Colonoscopy negative with deep ileal intubation Small bowel series negative
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Case Capsule endoscopy performed….
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Case Capsule endoscopy revealed: Apthous ulcerations Congested mucosa Hemorrhagic mucosa Findings consistent with small bowel Crohn’s Disease
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Case Patient initiated on budesonide 9 mg daily Considerable improvement with complete resolution of abdominal pain. CBC normalized
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Case Capsule endoscopy is superior to conventional techniques for early detection of Crohn’s disease. By early detection of small bowel lesions, CE can lead to earlier diagnosis and treatment, resulting in improved quality of life.
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References Gastrointestinal Endoscopy 2006;63(4):539-545. Triester et al. Am J Gastroenterol 2006;101:954-964. Faigel, DO and Cave, DR. Capsule Endoscopy. 2008 Elsevier Inc:91-104.
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