Question

question 22 (mandatory) (2 points)
a 24 - year - old is brought to the emergency room with symptoms of acute intestinal obstruction. his temperature 38°c(101°f), respirations are 25 per minute, and blood pressure is normal. physical exam reveals a mass in the right lower abdominal quadrant. exploratory surgery reveals there are numerous small bowel strictures and a fistula extending into a loop of small bowel. which of the following is the most likely diagnosis?
carcinoid tumor
crohns disease
ulcerative colitis
pseudomembranous colitis

Explanation:

1. Analyze each option:

• Carcinoid tumor: Usually presents with carcinoid syndrome (flushing, diarrhea, etc.) or mass - related symptoms, but not typically with multiple small bowel strictures and fistulas as described.
• Crohn's disease: It is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract. It is characterized by transmural inflammation, which can lead to strictures (narrowing of the bowel) and fistulas (abnormal connections between organs or tissues). The presence of multiple small bowel strictures and a fistula, along with the right - lower abdominal mass and systemic symptoms (fever), is highly consistent with Crohn's disease.
• Ulcerative colitis: Primarily affects the colon and rectum, and is characterized by continuous mucosal inflammation. It does not typically cause small bowel strictures or fistulas.
• Pseudomembranous colitis: It is usually associated with antibiotic use and is characterized by the presence of pseudomembranes in the colon, not small bowel strictures and fistulas.

1. Based on the above analysis, the symptoms of multiple small bowel strictures, a fistula, and the location (right lower abdominal quadrant) are most consistent with Crohn's disease.

Answer:

B. Crohn's disease