A 21-year-old male with a pediatric history of abdominal discomfort had experien

Question

A 21-year-old male with a pediatric history of abdominal discomfort had experienced recent weight loss and was suspected of suffering from anorexia nervosa. However, a Gastroenterologist examined him further and initially found evidence of colitis. Additional tests were ordered. The results of the tests revealed diverticulosis and three internal hemorrhoids. These findings indicated a diagnosis of Crohn disease. The treatment program for this chronic disease included a hemicolectomy and hemorrhoidectomy. 1. What symptoms would have lead the physician to suspect the diagnosis of anorexia nervosa? 2. What is colitis? 3. What is diverticulosis? 4. Chrohn disease is chronic, if the patient is given treatment, might it come back? 5. Describe the procedures that were done as treatment.

Explanation / Answer

1.The patient has pediatric history of abdominal discofort and recent weight loss. Sudden weightloss in young adult boy of 21 years lead the physician to suspect as anorexia nervosa.

2. Colitis occurs in the colon but not in the small intestines. The inflammation is limited to mucosa. Bowel wall is not thickened liken in Crohn’s disease. Rectal mucosa is affected initially but the disease may progress to entire colon. In severe cases, ulcerated mucosa may cause bleeding that results in bloody diarrhea. Perforation of colon may be caused with the bowel contents escaping into peritoneal cavity. Prolonged ulcerative colitis may cause carcinoma of colon or rectum.

3. The out pouching of mucosa from colon is projected into weak areas of muscular wall of large intestine. The out pouchings are called diverticula and the condition is called diverticulosis. The diverticula with bits of fecal matter trapped within the pouches result in inflammation called diverticulitis. The inflammation is followed by scarring and may cause perforation of diverticulum leading to abscess formation in pelvis.

4. Crohn’s disease is characterized by chronic inflammation and ulceration of the bowel mucosa with significant thickening and scarring of the bowel wall. The distal ileum is the site involved and is affected. The inflammation affects the small bowel with intervening segments of bowel in between the areas of severe disease. Thickening and scarring of the segment of bowel causes narrowing of lumen or it may be completely blocked obstructing passage of bowel contents. Crohn’s disease is called a regional ileitis due to inflammatory process is localized to distal ileum. Sometimes, the disease may involve colon also. Removal of part of blocked part of ileum and colon may not cause recurrence of the condition.

5. Gastroenterologist examined the patient to diagnose colitis and also additional tests have been carried out that resulted in diagnosis of diverticulosis and internal hemorrhoids and crohn's disease. The treatment given for this chronic condition is hemicolectomy and hemorrhoidectomy.

5.

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