Abstract
Diagnosis of small bowel Crohn's disease can be difficult in endoscopically inaccessible locations. Clinical diagnosis and suspicion coming from results of imaging techniques on the contrary may not lead to a correct diagnosis.
A 31 years old woman examined more than 7 months for anemia and gastrointestinal problems, treated several months for Crohn's disease is an example. Capsule endoscopy did not exclude intestinal inflammation, but led to a deadlock of the capsule and to surgery indication.
Locally advanced cancer of the small intestine was found peroperatively and solved by resection. The patient is now more than 4 years without signs of cancer recurrence.
This experience leads us to consider early surgical revisions in patients where findings typical for Crohn's disease are not entirely clear, in patients where the disease location is poorly accessible for examination, and in patients who do not react to initial conservative treatment completely.