2025, Number 1
Comprehensive management of Crohn´s disease, initial manifestation with anal fistulas: clinical case and therapeutic strategies
Full text
10.35366/121668
Language: Spanish
References: 9
Page: 5-9
PDF size: 1114.87 Kb.
ABSTRACT
Crohn's disease is an inflammatory bowel disease considered a chronic pathology characterized by a progressive inflammatory disorder, of inflammatory etiology, multifactorial, with an important autoimmune component, it can affect any segment of the gastrointestinal tract, and is the cause of complications of the gastrointestinal tract, the most frequent are rectal stenosis, fissures and anal fistulas. As for its pathophysiology, the genomic characteristics of this disease are characterized by the presence of mutations in the genes ATG16L1, IL23R, IRGM and NOD2 affecting the presence or absence of bacteria in the intestine. Therapeutic strategies include the use of immunosuppressive agents, biological therapies, and sometimes surgical interventions, which are critical for symptomatic control and prevention of long-term complications. We present the case of a 44-year-old male patient with a history of arterial hypertension with the presence of pruritus in the perianal region followed by progressive increase in volume, pain and induration, referred to the colon and rectum service due to persistence of symptoms, deciding on surgical management where drainage and debridement of abscess is performed, three fistulous tracs were found, colonoscopy was requested with a diagnosis of probable inflammatory bowel disease, and extraintestinal manifestations such as recurrent oral aphthous ulcers, peripheral arthropathy type 1, erythema nodosum and normochromic normocytic anemia, it was decided to initiate immunosuppression. The patient is an ideal candidate for antitumor necrosis factor (TNF) therapy. This case underscores the importance of a multidisciplinary approach to the management of Crohn's disease, integrating aggressive medical treatment, expedited surgical interventions, and rigorous clinical follow-up to improve clinical outcomes and patient quality of life.REFERENCES
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