Intestinal Research

Case Reports

IBD

Pediatric Crohn’s disease with severe morbidity manifested by gastric outlet obstruction: two cases report and review of the literature: Eun Sil Kim, Ji Hyung Park, Yon Ho Choe, Mi Jin Kim; Intest Res 2021;19(4):472-477. Published online October 29, 2020; DOI: https://doi.org/10.5217/ir.2020.00072

Crohn’s disease (CD) presenting as gastric outlet obstruction is rare but serious clinical presentation of CD causing severe morbidity. However, there have been few case reports concerning this disorder in East Asian children and adolescents. The current case report describes 2 pediatric patients with CD who had had gastric outlet obstruction as an initial symptom of CD. Two pediatric patients developed postprandial vomiting, bloating, and unintentional weight loss. The upper endoscopy result indicated that there was pyloric obstruction with mucosal edema, inflammation and ulcers. The serologic test and colonoscopy results suggested CD. These patients were treated with infliximab, and endoscopic balloon dilation without surgery and showed remarkable improvement in obstructing symptoms with maintaining clinical and biochemical remission. This case report elucidates the benefits of early intervention using infliximab and endoscopic balloon dilation to improve gastric outlet obstruction and achieve baseline recovery in patients with upper gastrointestinal B2 phenotype of CD.

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Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clinical and Experimental Pediatrics.2022; 65(1): 21. CrossRef

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A Case of Pyoderma Gangrenosum of the Face Associated with Ulcerative Colitis: Eun Sil Kim, Min Ho Seo, Hyuk Soon Choi, Bora Keum, Yeon Seok Seo, Yong Sik Kim, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu; Intest Res 2011;9(3):225-229. Published online December 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.3.225

Abstract PDF: Ulcerative colitis is associated with various extra-intestinal manifestations, including rheumatic, dermatologic, ophthalmologic, biliary, and hematologic manifestations. Cutaneous findings are common extra-intestinal manifestations of ulcerative colitis, occurring in 10-20% of patients. Cutaneous manifestations include erythema nodosum, pyoderma gangrenosum, aphthous stomatitis, and acute febrile neutrophilic dermatosis. Treatments for these cutaneous manifestations include corticosteroids, cyclosporine, tacrolimus, mycophenolate mofetil, azathioprine, and infliximab. A 48-year-old male presented with an acute exacerbation of ulcerative colitis associated with multiple skin lesions on his face, thumbs, thighs, and feet. The final impression was neutrophilic folliculitis, which is an early form of pyoderma gangrenosum. The patient's skin lesions and colitis both improved with corticosteroids. There are rare published case reports of ulcerative colitis exacerbations associated with pyoderma gangrenosum that initiated as neutrophilic folliculitis of the face. This case report includes a review of the literature. (Intest Res 2011;9:225-229)

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