Successful Double Balloon Enteroscopy Guided Evaluation of Ileal Stricture in a 34 Y.O. Male with Crohn’s Disease
PACE Hospitals’ expert Gastroenterology team successfully performed a Double Balloon Enteroscopy (DBE) on a 34-year-old male patient diagnosed with Crohn’s disease, associated with mild ileal stricture and sub-acute intestinal obstruction. The procedure aimed to assess the extent of Crohn’s disease, evaluate the strictures and prevent further complications.
Past Medical History
The patient had a history of recurrent bloating with borborygmi (normal rumbling, gurgling, or growling sounds from the stomach and intestine) lasting 1-2 days, which was relieved after passing stools or vomiting.
On Examination
On examination, the patient was conscious, coherent and oriented. Vital signs were normal, temperature was normal, and the oxygen saturation was normal. Abdominal tenderness was noted in the right iliac fossa.
Diagnosis
Upon admission to PACE Hospitals, the patient was thoroughly evaluated by the Gastroenterology team. He presented with severe abdominal pain in the right iliac fossa associated with two episodes of watery, loose stools, vomiting and fever. He had a history of recurrent bloating and borborygmi, which relieved after passing stools or vomiting.
The patient underwent some diagnostic evaluation. Ultrasound abdomen of the patient showed mild wall edema likely enteritis. All the routine laboratory investigations, like complete urine examination (CUE), liver function tests (LFTs), renal function tests (RFTs), culture and sensitivity tests, were done, and the complete blood picture revealed leucopenia (low white blood cell count) and low haemoglobin.
Based on the confirmed diagnosis, the patient was advised to undergo Crohn's disease Treatment in Hyderabad, India, under the expert care of the Gastroenterology Department, to manage the condition and prevent complications.
Medical Decision Making
After a detailed consultation with the consultant gastroenterologists, Dr. Govind Verma, Dr. Padma Priya, Dr. M Sudhir, a thorough evaluation was conducted considering the patient complaints of severe abdominal pain in the right iliac fossa, vomiting and fever, with a history of recurrent bloating and borborygmi. All relevant laboratory and imaging investigations were reviewed.
Based on the clinical and imaging investigations, it was determined that double balloon enteroscopy (DBE) was identified as the most appropriate intervention to dilate strictures, relieve symptoms and prevent further complications associated with this disease.
The patient and his family were counselled regarding the diagnosis, the procedure, risks and its potential to relieve symptoms and enhance the quality of life.
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