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P165. Pseudotumoral colonic form of Crohn's disease: a series of 16 cases

M. Fekih1, M. Cheikh1, A. Laabidi1, H. Debbabi1, N. Ben Mustapha2, J. Boubaker1, L. Kallel1, A. Filali1, 1La Rabta hospital; Tunis El Manar university, Gastroenterology “A”, Tunis, Tunisia, 2La Rabta Hospital, Gastro A Unit, Tunis, Tunisia

Background

Pseudotumoral colonic or rectal form of Crohn's disease is a rare entity. Preoperative diagnosis is very difficult. The diagnosis is usually based on the pathological examination of the surgical specimen.

Aim: Assessing the frequency, circumstances of diagnosis and management of pseudotumoral form of Crohn's disease.

Methods

We have conducted a retrospective chart review of patients who were admitted to hospital for Crohn's disease over six years (2005–2011). Only patients with pseudotumoral form of Crohn's disease were included.

Results

Over the 6-year period, 387 cases of Crohn's disease were reviewed. Sixteen patients with pseudotumoral form inaugurating Crohn's disease were included. The prevalence of this form was 2%. There were 9 males and 7 females. Mean age was 43 years (14–65 years). Obstruction and pseudo-obstruction were the presenting symptoms of the disease in respectively 9 and 3 patients. Fever and acute right iliac fossa pain were identified in 4 patients. In patients who were operated on immediately, the per-operative diagnosis was right colonic tumor (9 cases). The remaining patients were investigated with colonoscopy and CT scanner and were diagnosed with colonic or ileal tumors, nevertheless biopsies were negative. In the latter patients surgery was referred to for diagnostic and therapeutic aim. Diagnosis of pseudotumoral form of Crohn's disease was made only on the basis of the pathology examination of the surgical specimen.

Conclusion

Pseudotumoral form of Crohn's disease is extremely rare. Despite the improvement of morphological investigation, definitive diagnosis could be made only after pathological examination of the surgical specimen.