Are You Sure I Have Crohn’s Disease? Making the Proper Diagnosis, Avoiding IBD Mimickers, and Diagnostic Pitfalls


Infection

Mechanical

Inflammatory

Neoplastic

HIV

Pill esophagitis

Celiac sprue

Lymphoma

HSV

Rectal prolapse

Behcet’s disease

Leukemia

CMV

Solitary rectal ulcer syndrome

Segmental colitis associated with diverticular disease

Kaposi’s sarcoma

Clostridium difficile

Radiation damage

Autoimmune enteritis
 
Tuberculosis

Meckel’s diverticulum

Endometriosis
 
Histoplasmosis
 
Colon prep effect
 
Yesinia
 
Ipilimumab-induced colitis
 
LGV
   


If we make our way down the gastrointestinal tract, mimics of Crohn’s disease in the esophagus include viral infections like herpes simplex virus (HSV) and human immunodeficiency virus (HIV). Pill esophagitis also causes dysphagia with deep, single ulcers. In the small bowel, infections that can mimic Crohn’s disease include tuberculosis and Yersinia. While Giardia lives in the small intestine, it does not cause mucosal damage. Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and angiotensin-renin blockers (ARB) can cause ulcerations and enteritis [3]. Celiac disease and otherwise unspecified autoimmune enteritis cause chronic diarrhea, pain, and malabsorption syndromes with inflammatory changes on imaging. Neoplasm like lymphoma, infiltrative leukemia, and metastatic lesions can look like Crohn’s. Endometrial implants can cause pain and bleeding and cause an abnormal appearance to the lumen. A Meckel’s diverticulum that has become ulcerated can mimic Crohn’s disease as well.

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Jun 5, 2017 | Posted by in GASTROENTEROLOGY | Comments Off on Are You Sure I Have Crohn’s Disease? Making the Proper Diagnosis, Avoiding IBD Mimickers, and Diagnostic Pitfalls

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