Inflamed
Gastrointestinal System
0
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M4_F1.jpg"}},{"insert":"\n\n"},{"insert":"Today has been unusually dull, and the clock seems to be moving ever so slowly.\n\nYou sigh and hope for something, anything to break the monotony.\n\nA few moments later, your wish is granted as a patient enters your office.\n\nYou immediately notice that he looks rather thin and gaunt.\n"}]}
1
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M4_F2.jpg"}},{"insert":"\n\n"},{"insert":"Zachary, a 22 year old university student, complains of multiple episodes of abdominal pain and diarrhea over the last few months.\n\nHe also mentions that he has lost a lot of weight over the same time period.\n\nHe is not on any medications, and denies recreational drug usage. He does smoke heavily, consuming between 1 to 2 packs of cigarettes each day.\n\nZachary also informs you that he is at a critical point in his college course, and that he is extremely worried about missing classes.\n"}]}
2
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M4_F3.jpg"}},{"insert":"\n\n"},{"insert":"You proceed to the examination, and calculate his BMI to be 17.5 kg\/m2. He is also mildly pale.\n\nZachary\u0027s abdomen is diffusely tender, without any evidence of organomegaly or free fluid.\n\nDigital rectal examination reveals no abnormalities, aside from a single anal skin tag.\n\nA complete blood count (CBC) is only significant for a hemoglobin level of 11.5 g\/dL. All other hematological and biochemical investigations are within normal parameters.\n"}]}
3
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M4_F4.jpg"}},{"insert":"\n\n"},{"insert":"You decide that a colonoscopy is indicated, and ask Zachary to return a few days later, following bowel preparation.\n\nDuring the colonoscopy you note the presence of extensive ulceration of the colon, with features compatible with Crohn\u0027s disease (CD). You obtain multiple biopsies from the ulcers.\n\nUnfortunately, the distal ileum is markedly stenosed, and you find yourself only able to visualize the last few centimeters.\n"}]}
4
{"ops":[{"insert":"You realize that you need to determine the full extent of the disease. But how?\n"}]}
1. Via Capsular Endoscopy
2. Via a Barium Follow Through
3. Via MRI Enterography
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