N 1–2 (179–180) 2022. P. 87–91

FEATURES OF DIAGNOSIS AND TREATMENT OF CROHN’S DISEASE (CLINICAL CASE)

I. M. Todurov, O. V. Perekhrestenko, O. K. Prokhorenko,
V. Ye. Kupets, O. O. Panasenko, O. I. Plehutsa, O. M. Baka, O. V. Pechyborshch, V. P. Maidaniuk

State Scientific Institution “Center of Innovative Medical Technologies of the National Academy of Sciences of Ukraine”, Kyiv, Ukraine
Main Military Medical Clinical Center (Central Clinical Hospital of the State Border Service of Ukraine), Kyiv, Ukraine
Odesa National Medical University, Odesa, Ukraine

DOI 10.54229/2226-2008-2022-1-2-15

The exact reason for the occurrence of Crohn’s disease remains unknown. It is believed that pathology can be carried out by infectious and viral pathogens, deviations from the norm of natural balance of the microflora of the gastrointestinal tract (hereinafter – the gastrointestinal tract). Many researchers indicate an abnormal autoimmune response of the body on food stimuli – in favor of such an assertion indicates the systematic impression of the internal organs. However, for the emergence and development of this disease, there are significant impacts with harmful habits, such as: smoking, alcoholic beverages and medicines, unbalanced nutrition and the presence of chronic inflammatory gastroids. The inflammatory process begins in the mucous membrane, gradually affects all layers of the wall of the gastrointestinal wall, leads to its destruction and fibrosis and the formation of fistish and stenoses. Therefore, early diagnosis and timely treatment prevents the development of complications, including such severe such as bleeding, perforation of the intestinal wall, intra-abdominal abscesses, internal and external fists, adhesions of the intestine with the development of obstruction.

Purpose: on the basis of a specific case of HC to investigate and analyze the features of diagnosis and treatment of these patients using an analytical method and a systematic approach.

Materials and methods: The material was a clinical case of HC, methods of instrumental diagnosis and objective analysis.

The results: The concrete case of HC is investigated, features of inspection and diagnostics are defined.

Conclusions: A feature of the diagnosis and treatment of patients with HC is a constant vigilance about the occurrence of complications, the key to the prevention of which is a multidisciplinary approach in the tactics of diagnosis and treatment of these patients.

Key words: Crohn’s disease, features of examination and diagnosis.

 

REFERENCES

  1. Grigoriev GA, Meshalkina NYu. Crohn’s disease. Moscow: Medicine, 2007 (in Russian).
  2. Oistein Houde, BjomAMoum. Epidemiology and clinical course of Crohn′s disease. Results from observational studies. World Journal of Gastroenterology: WJG. 2012-04-21. T. 18. P. 1723–1731.
  3. Gert Van Asche, Axel Dignass, Julian Panes, Laurent Beaugerie, John Karagiannis. The Second European evidence – based Consensus on the diagnosis and Management of Crohn′s disease : Definitions and Diagnosis. Journal of Crohn′s and Colitis. 2010-02-01. Vol. 4, iss. 1. Р. 7–27. ISSN 1876-4479 1873-9946. DOI: 10.1016, J.Crohn′s, 2009/12/003/.
  4. Silverberg MS. Toward and integratеd clinical, molecular and serological classification of inflammatory bowel disease : Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology (M.S. Silverberg, J. Satsangi, T. Ahmad et al.). Can.J, Gastroenterol. 2005; 19. Sappl. A: 5–36.
  5. Daperno M. Development and Validation of a new simplified endoscopic activity score for Crohn’s disease : the SES-CD (M. Daperno, G.D. Haens, G. Vav Assche et al.). Gastrointest. Endosc. 2004; 60: 505–512.
  6. Simonova EV, Boyko TI. Endoscopic diagnosis of Crohn’s disease. Ukrainian journal of minimally invasive and endoscopic surgery. 2011; 15(3): 18–24 (in Russian).
  7. Gasche C., Brynskov J., et al. A simple classification of Crohn′s disease : report of the working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflam.Bowel Dis. 2000, 6:8–15.
  8. Yevtushenko OI, Myasoyedov DV, Shevelyuk SB. Colon endoscopy: a study guide. Kyiv: Vistka. 2007; 292 (in Ukrainian).
  9. Michael V., Sivak, Jr. Gastroenterologic Endoscopy. WB/Saunders Company, 1987; 1168.
  10. Endoscopy of the alimentary canal. Norm, pathology, modern classifications / V.Y. Kimakovich and others. Lviv: Medicine of the world, 2008; 208 (in Ukrainian).
  11. Handbook of classifications used in gastrointestinal endoscopy: teaching aid / ed. prof. A.M. Unreadable. Nizhny Novgorod: NizhGMA, 2017. 217 (in Russian).
  12. Nikishaev VI, Tumak IM, Vrublevska OO. Endoscopic classifications and algorithms. Kyiv, 2020; 31 (in Ukrainian).
  13. Maltsev D.V. Institute of Immunology and Allergology of NSU named after O.O. “Deficit of MZB” of Bogomolets. Ukrainian therapeutic magazine. 2015; 1: 80–89 (in Ukrainian).
  14. Crohn’s disease. Adapted evidence-based clinical practice. 2015 / State Expert Center. All-Ukrainian Association of Gastroenterologists (in Ukrainian).
  15. Chemotherapy Center of Spizhenka Clinic. URL: https://spizhenko.clinic/uk/tsentr-himioterapii-uk (in Ukrainian).
  16. Spectrum of pharmacological activity of monoclonal antibodies / G.V. Zaichenko et al. Ukrainian Journal of Medicine, Biology and Sports. 4: 5(21): 17–32 (in Ukrainian).
  17. Colombel J.F., Sandborn W.J., Rutgeerts P., Enns R., Hanauer S.B., Panaccione R., Pollack P.F. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology. 2007; 132(1): 52-65. PMID: 17241859. DOI: 10.1053/j.gastro.2006.11.041.
  18. Cherry L.N., Yunker N.S., Lambert E.R., Vaughan D., Lowe D.K. Vedolizumab: an α4β7 integrin antagonist for ulcerative colitis and Crohn’s disease. Therapeutic advances in chronic disease. 2015; 6(5): 224-33. PMID: 26336591. PMCID: PMC4549690. DOI: 10.1177/2040622315586970.
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