A 40 year old male presents with chronic diarrhea for one year. On investigation, the findings obtained were crypt abcess, crypt atrophy, cryptitis and mucositis. Most likely diagnosis is –
Correct Answer: Crohn's disease
Description: Crohn's disease The major symptoms are abdominal pain, diarrhoea and weight loss. Ileal Crohn's disease may cause subacute or even acute intestinal obstruction. The pain is often associated with diarrhoea, which is usually watery and does not contain blood or mucus. Almost all patients lose weight because they avoid food, since eating provokes pain. Weight loss may also be due to malabsorption and some patients present with features of fat, protein or vitamin deficiencies. Crohn's colitis presents in an identical manner to ulcerative colitis but rectal sparing and the presence of perianal disease are features that our a diagnosis of Crohn's disease. Many patients present with symptoms of both small bowel and colonic disease. A few patients present with isolated perianal disease, vomiting from jejunal strictures or severe oral ulceration. Physical examination often reveals evidence of weight loss, anaemia with glossitis and angular stomatitis. There is abdominal tenderness, most marked over the inflamed area. An abdominal mass may be palpable and is due to matted loops of thickened bowel or an intra-abdominal abscess. Perianal skin tags, fissures or fistulae are found in at least 50% of patients Ref Davidson edition23rd pg817
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