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Colonic adenocarcinoma revealing Crohn's disease: a case report

DOI: 10.1186/1752-1947-4-167

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Abstract:

A 70-year-old Arabic African man with undiagnosed Crohn's disease presented with acute abdominal obstruction due to an occlusive carcinoma of the sigmoid. At laparotomy, the colonic tumor was excised with continuity restored by end-to-end anastomosis.The risk of colonic carcinoma in Crohn's disease is increasing. Several case reports actually support the possibility that a genuine association between these two conditions exists.Colorectal cancer occurring in ulcerative colitis was described in 1925 by Crohn [1] but not until 23 years later did Warren and Sommers report the first case of adenocarcinoma complicating regional enteritis [2]. For the next 30 years, an increasing frequency of reports of single [3,4] and even multiple cases [4,5] failed to dispel the scepticism surrounding this association.A 70-year-old Arabic African man presented to the emergency department of the University Hospital Hassan II of Fez with a five-day intestinal obstruction with associated abdominal distension and vomiting. He denied intestinal bleeding or diarrhea. He gave a history of referred intermittent episodes of constipation for a period of 6 months.When examined he was found to have general abdominal tenderness. His white blood cell count was 8000 elt/ml, his haemoglobin was 11 gr/dl, and his platelet count was 350 k/ml. His abdominal X-rays showed air-fluid levels. Abdominal scanner examination revealed a distension of his small and large bowels upstream a sigmoid colon process (Figure 1). A sigmoidoscopy showed a stricture of his sigmoid colon. Our patient was taken immediately to laparotomy, which confirmed the presence of an occlusive sigmoid tumor. A defunctioning sigmoidostomy was later performed on our patient. A colonoscopy through the stomy revealed colitis and ileitis. A resection of his sigmoid colon was performed with continuity restored by end-to-end anastomosis (Figure 2).Meanwhile, pathological examination of our patient showed a well-differentiated adenocarcinoma o

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