Mr. P.T., age 19, has had Crohn’s disease, affecting the ileum and part of the jejunum, for 5 years and has had numerous exacerbations. Several members of his extended family have a history of Crohn’s disease.
1. Describe the pathophysiology of Crohn’s disease.
2. Suggest several possible exacerbating factors for Crohn’s disease.
3. Describe the common signs of an exacerbation.
4. Explain how nutritional deficits may occur with Crohn’s disease.
5. P.T. has delayed growth. (He is much shorter than his classmates.) Suggest several specific contributing factors to retarded growth in a young person.
6. P.T. has developed a fistula between the ileum and the bladder. Describe the effect of a fistula. There is considerable risk of intestinal obstruction developing in P.T. at some point in the near future.
7. Explain how this obstruction could gradually form.
8. Suggest several manifestations, with the reason for each, of an acute obstruction in the ileum.
9. Describe the potential complications of an intestinal obstruction that is not treated promptly.