Diagnosis and differential diagnosis of Crohn's disease

Bockus (1964) believes that in cases where Crohn's disease has a certain clinical manifestations, diagnosis is established without difficulty, if the doctor is aware of the existence of this disease. Reasonable suspicion should arise, the combination of persistent diarrhea with abdominal pain, fever, perianal, perirectal and outer fistula. In some cases, palpation of the abdomen defined tumor, often in the right iliac fossa. However, in the diagnostic most reliable should be considered as x-ray data that are crucial. Sigmoidoscopy allows to reveal hidden perirectal complications and to specify the nature of ulcers in the rectum and the sigmoid colon.
Laboratory and biochemical methods do not yet have a real help in the recognition of Crohn's disease. Many of the patients have anemia combined with weight loss.
Often the disease is asymptomatic and is accidental discovery during surgery or autopsy table.
Crohn's disease with a defeat of the colon is often differentiated from non-specific ulcerative colitis. Detailed information about differential diagnostic criteria of these two diseases are presented in table. 5.

In order differential diagnosis should use all the available methods. In some cases, play a decisive role clinical and radiologic data, and other changes with rectoromanoscopy in combination with the results of pathohistological studies bioptic material (Lennard-Jones and others, 1968). In cases of suspected intestinal infection or sarcoidosis Beck becomes absolutely necessary in vivo histology section of the intestine or lymph node, because the clinical picture is not always an opportunity to make a correct diagnosis. For some patients resort to diagnostic laparotomy.
Sometimes you need to differential diagnosis with a large group kollagenozov (often with scleroderma). When a relative of community clinical manifestations final diagnosis of Crohn's disease can only be installed after x-ray.