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Azmi N, Tiew Toot Chaw W, Abdul Rahman N, Zaihan S, Ahmad Kammal WSE. The Enigma of Crohn's Disease: A Case Report. Cureus 2024; 16:e55993. [PMID: 38606263 PMCID: PMC11007285 DOI: 10.7759/cureus.55993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/13/2024] Open
Abstract
Crohn's disease (CD) is an inflammatory condition affecting the gastrointestinal tract, often leading to persistent inflammation in various parts, notably the terminal ileum and colon. Clinical manifestations of CD can become complex due to complications like strictures, fistulas, and perianal abscesses. The disease typically exhibits transmural inflammation and skip lesions, where unaffected areas alternate with affected ones. Treatment goals focus on achieving disease remission and preventing complications that may require surgical intervention. Surgery becomes crucial in managing complications such as Crohn's strictures and perforations. Here, we describe a challenging case involving a young woman who underwent surgery for abdominal abscess and with Crohn's stricture and fistula.
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Affiliation(s)
- Nabil Azmi
- Department of Surgery, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, MYS
| | - Warren Tiew Toot Chaw
- Department of Surgery, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, MYS
| | | | - Sumayyah Zaihan
- Department of Pathology, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, MYS
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Rajbhandari R, Blakemore S, Gupta N, Adler AJ, Noble CA, Mannan S, Nikolli K, Yih A, Joshi S, Bukhman G. Crohn’s disease in low and lower-middle income countries: A scoping review. World J Gastroenterol 2020; 26:6891-6908. [PMID: 33268969 PMCID: PMC7684456 DOI: 10.3748/wjg.v26.i43.6891] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/04/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND While Crohn’s disease has been studied extensively in high-income countries, its epidemiology and care in low and lower-middle income countries (LLMICs) is not well established due to a lack of disease registries and diagnostic capacity.
AIM To describe the published burden, diagnostic/treatment capacity, service utilization, challenges/barriers to individuals with Crohn’s in LLMICs and their providers.
METHODS We conducted a scoping review utilizing a full search strategy was developed and conducted in PubMed, Embase and World Health Organization Global Index Medicus. Two independent reviewers screened the titles and abstracts of all of the publications found in this search, reviewed selected publications, and extracted relevant data, which underwent descriptive review and was analyzed in Excel.
RESULTS The database search yielded 4486 publications, 216 of which were determined to be relevant to the research questions. Of all 79 LLMICs, only 21 (26.6%) have publications describing individuals with Crohn’s. Overall, the highest number of studies came from India, followed by Tunisia, and Egypt. The mean number of Crohn’s patients reported per study is 57.84 and the median is 22, with a wide range from one to 980.
CONCLUSION This scoping review has shown that, although there is a severe lack of population-based data about Crohn’s in LLMICs, there is a signal of Crohn’s in these settings around the world.
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Affiliation(s)
- Ruma Rajbhandari
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
| | - Samantha Blakemore
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Neil Gupta
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
- Partners in Health, NCD Synergies, Boston, MA 02199, United States
| | - Alma J Adler
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
| | - Christopher Allen Noble
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
- Partners in Health, NCD Synergies, Boston, MA 02199, United States
| | - Sara Mannan
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Klejda Nikolli
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Alison Yih
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
| | - Sameer Joshi
- Western Reserve Health Education, Trumbull Regional Medical Center, Warren, OH 44483, United States
| | - Gene Bukhman
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02199, United States
- Partners in Health, NCD Synergies, Boston, MA 02199, United States
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