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A 37-year-old man with Crohn's disease was referred because of an enterocutaneous fistula. He had been taking six tablets of mesalamine and 20 mg of prednisone a day for three months. Because of constant nausea and vomiting, he had been receiving intravenous hyperalimentation. An upper gastrointestinal series showed dilatation of the stomach (curved arrow) and duodenum (straight arrow) to the ligament of Treitz as a result of retained pills. Upper gastrointestinal endoscopy showed ulcerations in the distal duodenum, a pinhole stricture distal to the third portion of the duodenum, and hundreds of retained pills. The patient underwent laparotomy, extensive lysis . . . [Full Text of this Article] |
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