RARE COMPLICATION OF CROHN’S DISEASE WITH LOCALIZATION IN THE INFLAMMATORY INTESTINE IN THE F0ORM OF THE SPREAD OF INFLAMMATORY OF THE PROCESS ON THE ANTERIOR ABDOMINAL WALL WITH FORMATION ABSCESS AND ITS DISCLOSURE IN THE NAVEL

  • O. A. Povch
  • S. O. Rebenkov
  • A. V. Kovalchuk
  • A. B. Bilyakov-Belskiy
  • V. M. Sidorenko
  • R. O. Martsenyuk
  • A. V. Azarenkov
Keywords: Crohn’s disease with abdominal complication, abscess in the umbilicus, fistula in the umbilical region, laparostomy, urgent computed tomography of the abdominal cavity and small pelvis.

Abstract

The purpose of the study. Show a rare variant of the clinical course of complications of Crohn’s disease (СD). To analyze the anamnestic data, symptoms, clinical manifestations, preoperative diagnosis, features of surgery, postoperative period and the results of histological examination in a patient with CD who had complications in the form of transition of inflammation from the ileal wall to the anterior abdominal wall with abscess formation, opening it in the navel and the formation of a fistula.

Material and methods. An analysis of the case of a complicated course of CD, manifested by the transition of inflammation from the ileum to the anterior abdominal wall, the formation of an abscess, its breakthrough into the navel and the formation of a fistula in the umbilical region. This complication was detected only after urgent computed tomography of the abdominal cavity and small pelvis (CTACSP).

Results. The patient, despite the history of complaints, performed appendectomy, in which the removed appendix did not fully correspond to the clinical manifestations and data of CTACSP, in which CD was suspected, did not complete the examination, was not consulted by gastroenterologists and proctologists. He was urgently hospitalized with a clinic similar to acute purulent omphalitis. Only careful collection of the anamnesis and performance of urgent CTACSP allowed to suspect existence at the patient of the complicated course of CD. This allowed us to predict the course of surgery, perform a right hemicolectomy with excision of the altered tissues of the anterior abdominal wall and suturing the wound in the form of a laparostomy. The patient’s condition improved, he was discharged from the hospital.

Conclusions. Patients with suspected CD should be monitored and treated by gastroenterologists and proctologists. Careful collection of anamnesis in patients of this group and the implementation of emergency CTACSP allowed to establish a correct diagnosis in the preoperative period.

References

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Published
2021-12-08
How to Cite
Povch, O. A., Rebenkov, S. O., Kovalchuk, A. V., Bilyakov-Belskiy, A. B., Sidorenko, V. M., Martsenyuk, R. O., & Azarenkov, A. V. (2021). RARE COMPLICATION OF CROHN’S DISEASE WITH LOCALIZATION IN THE INFLAMMATORY INTESTINE IN THE F0ORM OF THE SPREAD OF INFLAMMATORY OF THE PROCESS ON THE ANTERIOR ABDOMINAL WALL WITH FORMATION ABSCESS AND ITS DISCLOSURE IN THE NAVEL. Kharkiv Surgical School, (5-6), 66-70. https://doi.org/10.37699/2308-7005.5-6.2021.14
Section
CASE FROM PRACTICE

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