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Case Reports
. 2013 Jun 6:2013:bcr2013009603.
doi: 10.1136/bcr-2013-009603.

'Crohn'z meanz Heinz': foreign body inflammatory mass mimicking Crohn's disease

R Visagan  1 , R Grossman, P A Dimitriadis, A Desai
Affiliations
Case Reports

'Crohn'z meanz Heinz': foreign body inflammatory mass mimicking Crohn's disease

R Visagan et al. BMJ Case Rep. .

Abstract

The authors present a patient with a presumed diagnosis of Crohn's disease for 6 years turning out to be an unusual inflammatory mass caused by ileal perforation due to a foreign body. When surgical intervention became necessary for admissions with recurrent obstruction, laparoscopy revealed an inflammatory mass in the terminal ileum, exposing two pieces of plastic bearing the word 'Heinz'. Resection of the inflammatory mass led to the complete resolution of symptoms. Histology from the operative specimen showed no features of Crohn's disease. There were no granulomas and no fissuring ulcers. This case highlights that an inflammatory mass in the small intestine caused by the perforation of ingested foreign body can mimic Crohn's disease. To our knowledge, this is the first report of a synthetic plastic packaging causing ileo-caecal junctional perforation mimicking Crohn's disease.

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Figures

Figure 1
Figure 1
CT imaging—thickening of small bowel and terminal ileal inflammation. Mural hyperenhancement and increased mural thickness are the most sensitive CT findings of active Crohn's disease.
Figure 2
Figure 2
MRI enterography—non-specific inflammation of terminal ileum. MRI enterography allows the evaluation of bowel wall contrast enhancement, wall thickening and oedema, findings useful for the assessment of Crohn's disease activity.
Figure 3
Figure 3
Intraoperative image: dilated terminal ileum.
Figure 4
Figure 4
An unusual inflammatory mass.
See this image and copyright information in PMC

References

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