Failure to Diagnose & Delay in Treatment of Acute Abdomen Due to Crohn's Disease (Inflammatory Bowel Disease)

Evaluate breaches in the standard of care when addressing a Failure to Diagnose & Delay in Treatment of Acute Abdomen Due to Crohn's Disease (Inflammatory Bowel Disease)

Answer the following questions to find out if the standard of care was followed for your case.

  • With which of the following symptoms did the patient present? (Choose all that apply)
    Diarrhea with blood in stools
    Vague abdominal pain / post prandial abdominal pain / bloating
    Weight loss / malnutrition
    Perianal abscesses / anal fissures / rectovaginal fistula
    Apthous ulcer
    Anemia
    Not elicited
    None of the above
    Answer unknown
    Why is this important?
    Diarrhea is the most common complaint among patients with Crohn’s disease.
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  • With which of the following extra-intestinal manifestations did the patient present? (Choose all that apply) Why is this important?
    Answer this question
    Inflammatory bowel disease is associated with a number of extra-intestinal manifestations which can serve as markers for disease.
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  • With which of the following risk factors did the patient present? (Choose all that apply) Why is this important?
    Answer this question
    A risk factor is a variable that has a causal association with a disease or disease process; the presence of the variable in an individual or a population is associated with an increased risk of the presence or future development of the disease. Thus, risk factors may be useful for identifying subjects at increased risk for a disease or for a particular outcome that results from a disease process.
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  • Was a medical history obtained? Why is this important?
    Answer this question
    A complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's examination, enables the clinician to make educated evaluations, and be better equipped to advise the patient.
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  • Was a physical examination performed? Why is this important?
    Answer this question
    A complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's evaluation and enables the clinician to make the most judicious use of additional tests. The physical examination also plays a pivotal role in treatment decisions that must be addressed at various points throughout the patient's lifetime.
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  • Which of the following laboratory investigations were performed? (Choose all that apply) Why is this important?
    Answer this question
    Routine laboratory studies can provide important clues to diagnosis.
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  • Which of the following diagnostic imaging studies were performed? (Choose all that apply) Why is this important?
    Answer this question
    An MRI provides unsurpassed soft tissue contrast and multiplanar capability with spatial resolution.
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  • To which of the following was the patient referred? Why is this important?
    Answer this question
    Once a diagnosis has been made, and in many cases if a diagnosis is unclear, referral to the appropriate specialists needs to be made in a timely manner. To deliver care requires a coordinated approach that allows sharing of skills and expertise. The skills of members from all professional disciplines should be utilized.
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  • Which of the following diagnostic endoscopic procedures did the specialist perform? (Choose all that apply) Why is this important?
    Answer this question
    Colonoscopy with ileoscopy is the diagnostic procedure of choice for patients with colonic involvement and will usually confirm or exclude the diagnosis of Inflammatory Bowel Disease (IBD).
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  • Was a biopsy performed? Why is this important?
    Answer this question
    Biopsy may be obtained at the time of endoscopy.
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  • Was the patient diagnosed with Crohn’s disease? Why is this important?
    Answer this question
    The diagnosis of Crohn’s disease rests on the clinical presentation and histological evidence of chronic inflammation and granulomas of the gastrointestinal mucosa.
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  • Were follow-up evaluations advised? Why is this important?
    Answer this question
    Routine follow-up evaluations are necessary to offset any complications that may arise.
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  • Was histopathologic evaluation performed? Why is this important?
    Answer this question
    The diagnosis of Crohn’s disease is confirmed by findings on imaging studies, endoscopy, and usually histopathology.
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  • Which of the following medical interventions were offered to the patient? (Choose all that apply) Why is this important?
    Answer this question
    The treatment of Crohn’s disease includes medical therapy, nutritional therapy and surgical therapy. The life style modifications also play a vital role in the management of Crohn’s disease.
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  • Were antibiotics administered to the patient? Why is this important?
    Answer this question
    Antibiotics have a clear role in treating pyogenic complications of Crohn’s disease.
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  • Which of the following nutritional interventions were provided to the patient? (Choose all that apply) Why is this important?
    Answer this question
    Nutritional therapy in Crohn's disease conceivably has two purposes: repletion of nutrients and treatment of the primary disease.
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  • Which of the following life style modifications were suggested? (Choose all that apply) Why is this important?
    Answer this question
    Lifestyle modifications, such as smoking cessation, can limit the number of relapses in patients with Crohn's disease. Elemental diets are nearly as effective as oral corticosteroids in treating acute attacks of Crohn's disease.
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  • Was a surgical resection performed? Why is this important?
    Answer this question
    Surgery plays an integral role in the treatment of Crohn's disease to control symptoms and to treat complications.
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  • Were patient education / discharge instructions provided? Why is this important?
    Answer this question
    It is difficult to predict the course of Crohn’s disease and hence the clinician must provide appropriate information related to the disease to the patient or caregiver.
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