ELDERLY ONSET CROHN'S DISEASE WITH HIGH DISEASE ACTIVITY- A DIAGNOSTIC AND THERAPEUTIC CHALLENGE

Résumé fourni par la source

We present a case of an 82-year-old diabetic gentleman who presented with complaints suggestive of subacute intestinal obstruction. He was treated conservatively initially and improved. But, following radiological reports he was diagnosed as Elderly onset Crohn's disease with high disease activity. After proper screening, he was initiated on Anti-TNF alpha inhibitor but due to spontaneous intestinal perforation, it was discontinued. Emergency exploratory laparotomy was done, and he improved gradually post-op. Oral Mesalamine and Budesonide were then initiated, but due to frequent mood swings, worsening TLC, and liver enzymes, they were stopped. Lastly, antibiotic therapy was initiated with Oral ciprooxacin and metronidazole which improved his abdominal symptoms. He was discharged after optimization of his nutritional status. Hence, we present a case of difcult to manage elderly onset Crohn's disease with high disease activity

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