A patient with ileocecal Crohn’s disease who has intermittent umbilical and left lower abdominal quadrant pain
Here in we present a very rare case of Crohn’s disease who had a concurrent intestinal malrotation.
A 35-year-old woman was admitted to our outpatient clinic with diagnosis of Crohn’s disease. She had intermittant umblical and left lower abdominal pain. She hadn't any symptoms during her first 30 years of life. In her past medical history, she has been followed in an external center with the diagnosis of ileocecal Crohn’s disease for 3 years and she was taking 150 mg/day azathioprine and 3 gr/day mesalamine. Her physical examination and labarotory findings were unremarkable. An abdominal ultrasonography showed thickened mucosal layers of ileocecal valve and ileal wall. Also the whole colon segments were isolated to the left side, whereas all jejunal and ileal loops were localized in the right side of the abdomen. In her colonoscopy, ileocecal valve and distal terminal ileum was hyperemic and edometaous, while an abdominal computerized tomography revealed intestinal malrotation with the colon isolated to the left side and small intestine to the right side. We did not know about the malrotation and we had many technical problems when we performed the first colonoscopy. Although our cecal intubation time was too long and terminal ileum intubation was too difficult, we cannot recognize correctly the anatomic abnormality.