Case 12.2
A Magnetic Resonance Enterography (MRE) was performed for further evaluation:
The MRE suggests a diagnosis of fibrostenotic stricturing small bowel Crohn’s disease.
What is your next step in management? (select all that apply)
Perform capsule endoscopy to visualize small bowel disease
Capsule endoscopy would introduce a significant risk of capsule retention and should not be performed.
Refer to surgery for resection of small bowel strictures
Surgical resection can provide an opportunity for histologic confirmation.
Perform a double balloon enteroscopy to biopsy small bowel strictures
A double balloon enteroscopy can be done to confirm tissue diagnosis in this patient with HIV and a differential diagnosis that includes lymphoma.
Start biologic therapy for Crohn’s disease
Based on history and radiographic finds, stricturing small intestinal Crohn’s disease appears to be the diagnosis and the patient can be started on biologic therapy while considering surgical options