1. A CASE PRESENTATION ON
CROHN'S DISEASE
Presented by
A. Suresh
PharmD 5th year
194T1T0006
2. P
A
TIENT DEMOGRAPHIC DA
T
A
• Patient Name: Mrs. X
• Age/ gender:45 years/Female
• Department: Gastroenterology
• IP no : 2023
Chief complaints
• Vomiting's since 3 days
• Abdominal pain since 3 days
• Diarrhea since 3 days
3. PAST MEDICAL HISTORY
Nill
PAST MEDICATION HISTORY
Nill
Personal history:
Diet : mixed diet
Appetite : loss of appetite
Body weight:70 kg
GENERAL EXAMINATION
Patient is conscious and coherent
4. PHYSICAL EXAMINATION
• Temp: 98.4;f
• Pulse rate:88bpm
• BP:130/80 mm hg
SYSTEMIC EXAMINATION
• CVS: S1&S2 +
• CNS:NAD
• P/A:SOFT
• tenderness over the lower abdomen and
umbilical region
5. LAB INVESTIGATION
Parameters Observation Normal range
Hb 13.0 13-15 gm/dl
WBC 8,000 4,000 – 11,000 cumm
Sr. Creatinine 0.8 0.6 to 1.3 mg/dl
Sodium 132 135 to145 mmol/L
Potassium 3.3 3.5 to 5 mmol/L
Chloride 90 90 to 110 mmol/L
6. DIAGNOSIS
• CT Scan abdomen performed
IMPRESSION:
Inflammation process in the intestine without mass
• COLONOSCOPY was performed
IMPRESSION:
multiple colon ulcers with skip lesions
7. DRUG CHART
drug Category Dose Frequency ROA
Metocloprami
de
Dopamine
receptor
antagonist
10 mg TID IV
Morphine Opiod
analgesic
5 mg OD IV
PCT Analgesic or
anti pyretic
500 mg OD P/O
Buscopan Antispasmod
ic
20 mg OD IV
8. SUBJECTIVE FINDINGS
• A female patient of age 45 years was a admitted in general
medicine ward with complain ts of vomiting since 3 days
with nausea... abdominal pain and diarrhea a since 3 days.
OBJECTIVE FINDINGS
Ct scan: Inflammation process in the intestine without mass
Colonoscopy: multiple colon ulcers with skip lesions
• ASSESSMENT:
• Based on subjective and objective findings the case is
diagnosed as crohn’s disease
SOAP NOTES
9. DISEASE INFORMATION
DEFINITONS:
Crohn's disease is a chronic disease that causes inflammation
in the digestive tract. It can affect any part of the digestive
tract, But it usually affects the small intestine and the
beginning of large intestine
Types of Crohn's disease
1.Ileocolitis
2.Ileitis
3.Gastro duodenal chrons disease
4.Jejuno ilitis
10. ETIOLOGY:
• Exact cause is not known
• Alteration in bacterial microflora
• Smoking
• Alcohol
• Genetics
• Norovirus
• Nutrition deficiency
• Long term use of certain medications
eg: NSAIDS
12. Signs and symptoms
Pain , inflammation of the gut
Ulceration in gut
Vomitings
Mouth ulcer
Mild or moderate diarrhea
Fatigue
Weight loss
Anemia
DIAGNOSTIC TOOLS
USG ABDOMEN
CT SCAN
COLONOSCOPY
INTESTINAL ENDOSCOPY
13. TREATMENT
PHARMACOLOGICAL TREATMENT
1. 5 Amino salicylic acid (5-ASA)
Eg: Mesalamine, Mesalazine
2.Prednisolone and Methylprednisolone
3.Immuno modulators
Eg:Azathioprine,Mercaptopurine,Methotrexate,Ifliximab,ad
alimumab
4. Hydrocortisone should be used in severe conditions of
Crohn's disease.
