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Mimics of IBD

Mimics of IBD. Sunanda Kane MD MSPH Mayo Clinic Rochester. Mimics of IBD. Discrimination based on: Location Symptoms (including EIM) Endoscopic appearance Radiographic appearance. sgi Diagnostic. IBD-Specific Serologic Immune Markers. Mimics in Esophagus. HSV infection HIV ulcers

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Mimics of IBD

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  1. Mimics of IBD Sunanda Kane MD MSPH Mayo Clinic Rochester

  2. Mimics of IBD • Discrimination based on: • Location • Symptoms (including EIM) • Endoscopic appearance • Radiographic appearance

  3. sgi Diagnostic

  4. IBD-Specific Serologic Immune Markers

  5. Mimics in Esophagus • HSV infection • HIV ulcers • Pill esophagitis

  6. Colonic Ulceration: Crohn’s?

  7. Right sided Colonic Thickening: Crohn’s?

  8. MRE of Woman with EN and Abdominal Pain Normal!

  9. Small Bowel Mimics • TB, Yersinia • Neoplasm • Drugs- NSAIDs, SARBs • Celiac • Autoimmune enteritis NOS • Meckel’s diverticulum • Endometriosis

  10. Colon Mimics • Prep effect • Normal colon • Histo, CMV, C diff • Neoplasm- Kaposi’s sarcoma, leukemia • SRUS • Drugs-ipilimumab • SCAD

  11. Either Location • Radiation • Neoplasm • IBS • Bechet’s • Ischemia

  12. Perianal Mimics • Trauma: obstetric or GI surgery • Infection: TB, LGV • Ischemia • Neoplasm

  13. Small Bowel Obstruction in CD Patient

  14. Patient with Crohn’s and Pain

  15. Patient with Crohn’s and Continued Weight Loss

  16. Mimics of IBD • Consider alternative when high dose prednisone does not work • Always think about infection, ischemia or neoplastic process • Conditions can overlap, can have two entities at once

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