Would you start a biologic without a tissue diagnosis in a young male presenting with recurrent small bowel obstruction and MRE showing distal ileitis, which was unable to be reached despite repeat colonoscopy?

The patient was presumed to have Crohn's ileitis and improved on steroids. If so, what would you start?

Labs noted for negative stool infectious workup and elevated CRP.

Answer from: at Academic Institution

Thank you for your question. Not sure what “young” is, but in the differential are lymphoma and an inflamed Meckel’s diverticulum. You absolutely need tissue before you commit him to a biologic. Steroids can help with a lot of different things and should not be considered a diagnos...

Comments

at University of Texas at Austin Dell Medical School
Appreciate your insight, Dr. @Kane! It is a male i...

at Borland Groover Clinic Fernandina Beach
After recurrent admits for obstruction, he needs s...

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Would you start a biologic without a tissue diagnosis in a young male presenting with recurrent small bowel obstruction and MRE showing distal ileitis, which was unable to be reached despite repeat colonoscopy?

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