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Open Access Case report

Successful Non-Invasive treatment of stricturing fibrosing colonopathy in an adult patient

G Terheggen1*, D Dieninghoff2, E Rietschel2, U Drebber3, W Kruis4 and L Leifeld4

Author Affiliations

1 Department of Medicine, Evangelisches Krankenhaus Duesseldorf, Duesseldorf, Germany

2 CF-Center, Children's Hospital, University of Cologne, Cologne, Germany

3 Institute of Pathology, University of Cologne, Cologne, Germany

4 Department of Internal Medicine, Evangelisches Krankenhaus Kalk, Cologne, Germany

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European Journal of Medical Research 2011, 16:411-414  doi:10.1186/2047-783X-16-9-411

Published: 12 September 2011

Abstract

Objective

Fibrosing colonopathy (FC) is a rare entity associated with cystic fibrosis (CF). Until now, patients with stricturing FC have usually been treated surgically. In this instance, we aimed at avoiding surgery by applying a new conservative approach.

Methods

Case report on an adult with CF who developed persistent abdominal pain due to a non-passable stricture in the right transverse colon. Histology confirmed fibrosing colonopathy.

Results

Initially we treated the patient with prednisolone pulse therapy and additive antibiotic therapy. For maintenance therapy we administered budesonide. The patient underwent clinical, laboratory and endoscopic follow-up over a three-year period. The stricture healed and was easy to pass. A relapse in the cecum at the ileocecal valve again improved under steroid and antibiotic therapy.

Conclusions

We present a novel therapeutic approach for advanced stricturing FC in an adult patient which successfully avoided surgery (right hemicolectomy) over a three year follow up.

Keywords:
fibrosing colonopathy; cystic fibrosis; colonic stricture