16 years old | Female
A 16-year-old girl presents to emergency care with perianal pain and discharge. She reports a 2-year history of intermittent bloody diarrhea with nocturnal symptoms. On examination, she is apyrexial with normal vital signs. Her abdomen is soft and slightly tender on palpation in the left lower quadrant. Rectal examination is difficult to perform due to pain, but an area of erythematous swelling is visible close to the anal margin, discharging watery pus from its apex. Several anal tags are also present.
perianal pain | perianal discharge | 2-year history | intermittent diarrhea | bloody diarrhea | nocturnal symptoms | left lower quadrant tenderness | perianal erythematous swelling | discharging watery pus | Several anal tags
Crohn disease Inflammatory Bowel Diseases
https://online.epocrates.com/diseases/4222/Crohn-disease/Common-Vignette
Rank |
Disease |
Weight |
---|---|---|
1 | Intestinal Entamoeba histolytica amebiasis | 195.0 |
2 | Ulcerative Colitis | 141.0 |
3 | Hemolytic uremic syndrome | 129.0 |
4 | Mesenteric ischemia | 127.0 |
5 | mucosal Eosinophilic gastroenteritis | 120.0 |
6 | Anal Fissure | 114.0 |
7 | Bacterial gastroenteritis | 112.0 |
8 | Muscle Layer Eosinophilic gastroenteritis | 106.0 |
9 | subserosal eosinophilic gastroenteritis | 106.0 |
10 | Diverticulitis | 103.0 |
11 | Salmonella infection | 96.0 |
12 | Non-cholera Vibrio infections | 96.0 |
13 | Foodborne E coli infection | 93.0 |
14 | Graves Disease | 92.0 |
15 | Crohn Disease | 90.0 |
16 | Listerial gastroenteritis | 90.0 |
17 | Gastrointestinal Hemorrhage | 89.0 |
18 | Lower gastrointestinal hemorrhage | 89.0 |
19 | Upper gastrointestinal hemorrhage | 89.0 |
20 | Intestinal Pseudo Obstruction | 88.0 |
21 | Viral Gastroenteritis | 87.0 |
22 | Peritoneal dialysis associated peritonitis | 86.0 |
23 | Eosinophilic gastroenteritis | 81.0 |
24 | Giardiasis | 80.0 |
25 | Extraintestinal Entamoeba histolytica amebiasis | 79.0 |
26 | Abetalipoproteinemia | 78.0 |
27 | Hemorrhoids | 77.0 |
28 | Lactose intolerance | 76.0 |
29 | Shigellosis | 76.0 |
30 | Toxic Megacolon | 73.0 |
31 | Acute perforated appendicitis | 73.0 |
32 | Ruptured Tuboovarian abscess | 73.0 |
33 | Kawasaki disease | 72.0 |
34 | Campylobacter infection | 72.0 |
35 | Anal Cancer | 71.0 |
36 | Gastroenteritis | 71.0 |
37 | Type 1 Diabetes mellitus | 69.0 |
38 | Irritable Bowel Syndrome | 68.0 |
39 | Type 2 Diabetes mellitus | 67.0 |
40 | Cholera | 66.0 |
41 | Thrombotic thrombocytopenic purpura | 65.0 |
42 | Primary sclerosing cholangitis | 63.0 |
43 | Secondary Peritonitis | 63.0 |
44 | Duodenal Ulcer | 62.0 |
45 | Gastric Ulcer | 62.0 |
46 | Familial Mediterranean fever | 62.0 |
47 | Celiac Disease | 60.0 |
48 | Anaphylaxis | 60.0 |
49 | Diabetic Amyotrophy | 60.0 |
50 | Pheochromocytoma | 60.0 |
51 | Anthrax | 60.0 |
52 | Klebsiella pneumoniae liver abscess | 56.0 |
53 | Hyperthyroidism | 56.0 |
54 | Malaria | 56.0 |
55 | Brucellosis | 56.0 |
56 | Acute Appendicitis | 55.0 |
57 | Graves ophthalmopathy | 55.0 |
58 | Splenic abscess | 55.0 |
59 | Malt lymphoma | 54.0 |
60 | Intestinal malrotation | 52.0 |
61 | Autosomal Dominant Polycystic Kidney Disease | 51.0 |
62 | Systemic sclerosis | 51.0 |
63 | pancreatic cancer | 50.0 |
64 | Addison Disease | 50.0 |
65 | Polyarteritis nodosa | 50.0 |
66 | Choledochal Cyst | 50.0 |
67 | Zollinger-Ellison Syndrome | 49.0 |
68 | Hereditary Angioedema | 49.0 |
69 | Amebiasis | 49.0 |
70 | Food poisoning | 49.0 |
71 | Short bowel syndrome | 49.0 |
72 | Hypogammaglobulinemia | 49.0 |
73 | Splenic Infarction | 49.0 |
74 | Diabetes Mellitus | 48.0 |
75 | Rumination Syndrome | 46.0 |
76 | Spontaneous bacterial peritonitis | 46.0 |
77 | Sarcoidosis | 46.0 |
78 | Sigmoid volvulus | 45.0 |
79 | Acute bacterial meningitis in children | 44.0 |
80 | STI HIV Pharyngitis | 43.0 |
81 | Systemic lupus erythematosus | 43.0 |
82 | Exocrine pancreatic insufficiency | 43.0 |
83 | Acute viral meningitis | 43.0 |
84 | Chronic pelvic pain in women | 43.0 |
85 | Acute otitis media | 41.0 |
86 | Intra-abdominal abscess | 41.0 |
87 | Chronic Myeloid Leukemia | 41.0 |
88 | Stevens-Johnson syndrome | 41.0 |
89 | Aseptic meningitis | 41.0 |
90 | Alcoholic hepatitis | 40.0 |
91 | Alcoholic Fatty Liver | 40.0 |
92 | Pelvic inflammatory disease | 40.0 |
93 | Acute pelvic inflammatory disease | 40.0 |
94 | Liver Cirrhosis | 39.0 |
95 | Biliary cirrhosis | 39.0 |
96 | Primary biliary cirrhosis | 39.0 |
97 | Henoch-Schonlein purpura | 39.0 |
98 | Multiple endocrine neoplasia 2B | 39.0 |
99 | Autoimmune Pancreatitis | 38.0 |
100 | Amebic Liver Abscess | 37.0 |
101 | Medullary thyroid cancer | 36.0 |
102 | Multiple endocrine neoplasia 2A | 36.0 |
103 | Meckel diverticulum | 36.0 |
104 | Psoas Abscess | 35.0 |
105 | Travelers diarrhea | 34.0 |
106 | Foreign body ingestion | 34.0 |
107 | Epiploic appendagitis | 34.0 |
108 | Tuboovarian abscess | 33.0 |
109 | Ruptured ovarian cyst | 32.0 |
110 | Autoimmune hepatitis | 31.0 |
111 | Churg-Strauss Syndrome | 31.0 |
112 | Primary Myelofibrosis | 31.0 |
113 | Choledocholithiasis | 31.0 |
114 | Hereditary hemochromatosis | 30.0 |
115 | Pancreatic Pseudocyst | 30.0 |
116 | Diabetic Ketoacidosis | 30.0 |
117 | Intestinal Obstruction | 30.0 |
118 | Gastroparesis | 30.0 |
119 | Ovarian and fallopian tube torsion | 30.0 |
120 | Pyogenic Liver Abscess | 29.0 |
121 | Colorectal cancer | 29.0 |
122 | Acute peritonitis | 29.0 |
123 | Chronic Clonorchiasis | 28.0 |
124 | Endometriosis | 28.0 |
125 | Psoriasis | 28.0 |
126 | Familial adenomatous polyposis syndrome | 28.0 |
127 | Chronic Pancreatitis | 27.0 |
128 | Clostridium difficile infection | 25.0 |
129 | Pneumonia | 24.0 |
130 | Acute bacterial meningitis in neonates | 24.0 |
131 | Alcoholic Liver Disease | 24.0 |
132 | Ovarian Cancer | 24.0 |
133 | COVID19 | 23.0 |
134 | Alopecia areata | 23.0 |
135 | Liver disease | 22.0 |
136 | Hepatocellular carcinoma | 22.0 |
137 | Endometrial cancer | 22.0 |
138 | Tinnitus | 22.0 |
139 | Atypical pneumonia | 22.0 |
140 | Achilles tendinopathy | 22.0 |
141 | Achilles tendon rupture | 22.0 |
142 | Premenstrual syndrome | 21.0 |
143 | Testicular cancer | 21.0 |
144 | Tuberculous Peritonitis | 21.0 |
145 | Wilson disease | 20.0 |
146 | Alcoholic Liver Cirrhosis | 20.0 |
147 | Acute peptic ulcer | 20.0 |
148 | Disseminated intravascular coagulation | 20.0 |
149 | Analgesic nephropathy | 20.0 |
150 | Acromegaly | 20.0 |
151 | Ectopic Pregnancy | 20.0 |
152 | Ruptured ectopic pregnancy | 20.0 |
153 | Guillain-Barre syndrome | 19.0 |
154 | Migraine headache in adults | 19.0 |
155 | Influenza | 18.0 |
156 | Rocky Mountain spotted fever | 18.0 |
157 | Gastric cancer | 18.0 |
158 | Chronic Hepatitis | 18.0 |
159 | Amyloidosis | 17.0 |
160 | Acute intermittent porphyria | 16.0 |
161 | Budd Chiari Syndrome | 16.0 |
162 | Ascites | 16.0 |
163 | Intussusception | 16.0 |
164 | Systemic vasculitis | 16.0 |
165 | Cholangiocarcinoma | 15.0 |
166 | Von willebrand disease | 15.0 |
167 | Acute Myeloid Leukemia in adults | 15.0 |
168 | Parkinson disease | 15.0 |
169 | Gastric Volvulus | 15.0 |
170 | Acalculous Cholecystitis | 15.0 |
171 | Abdominal compartment syndrome | 15.0 |
172 | chronic acalculous cholecystitis | 15.0 |
173 | Adrenal crisis | 15.0 |
174 | Morton neuroma | 15.0 |
175 | Acute heart failure | 15.0 |
176 | Ovarian Torsion | 14.0 |
177 | Epidemic keratoconjunctivitis | 14.0 |
178 | Hypothyroidism | 14.0 |
179 | Acute pericarditis | 14.0 |
180 | Infectious mononucleosis | 13.0 |
181 | Chronic Lymphocytic Leukemia | 13.0 |
182 | Endometritis | 13.0 |
183 | Ovarian Hyperstimulation Syndrome | 12.0 |
184 | Peptic Ulcer | 12.0 |
185 | Annular pancreas | 12.0 |
186 | Cystic Fibrosis | 12.0 |
187 | Gastritis | 11.0 |
188 | Glomerulonephritis | 11.0 |
189 | Diabetic Neuropathy | 10.0 |
190 | Painless thyroiditis | 10.0 |
191 | Renal vein thrombosis | 10.0 |
192 | Chronic Renal vein thrombosis | 10.0 |
193 | Acute Renal vein thrombosis | 10.0 |
194 | Cushing syndrome | 10.0 |
195 | Pulmonary Embolism | 10.0 |
196 | Pressure ulcer | 10.0 |
197 | Acute Clonorchiasis | 9.0 |
198 | Heparin-induced thrombocytopenia | 9.0 |
199 | Mallory-Weiss syndrome | 9.0 |
200 | Angiodysplasia of the colon | 9.0 |
201 | Goiter | 9.0 |
202 | Diffuse nontoxic goiter | 9.0 |
203 | Toxic multinodular goiter | 9.0 |
204 | Obstructive cervical goiters | 9.0 |
205 | Cervical goiter | 9.0 |
206 | Chronic bacterial prostatitis | 9.0 |
207 | Osteomyelitis | 9.0 |
208 | Peutz-Jeghers Syndrome | 8.0 |
209 | Allergic rhinitis | 8.0 |
210 | Common cutaneous drug reactions | 8.0 |
211 | Typhoid infection | 8.0 |
212 | Ankylosing spondylitis | 7.0 |
213 | Herpes zoster | 7.0 |
214 | Discogenic low back pain | 7.0 |
215 | Ileus | 7.0 |
216 | Dyspepsia | 7.0 |
217 | Musculoskeletal sprains and strains | 7.0 |
218 | Hiatus hernia | 6.0 |
219 | Inguinal hernia | 6.0 |
220 | Cellulitis | 6.0 |
221 | Animal bites | 6.0 |
222 | Achalasia | 5.0 |
223 | Common cold(adults) | 5.0 |
224 | Common cold(children) | 5.0 |
225 | Hepatorenal Syndrome | 4.0 |
226 | Mitral Stenosis | 4.0 |
227 | Ramsay Hunt syndrome | 4.0 |
228 | Psoriatic arthritis | 4.0 |
229 | Meniere disease | 4.0 |
230 | Bed bugs | 4.0 |
231 | Hyperprolactinemia | 4.0 |
232 | Leiomyomas | 4.0 |
233 | Lung Cancer | 3.0 |
234 | Thyroid lymphoma | 3.0 |
235 | Acute Rhinosinusitis | 3.0 |
236 | Acute viral rhinosinusitis | 3.0 |
237 | Acute bacterial rhinosinusitis | 3.0 |
238 | Anaplastic thyroid cancer | 3.0 |
239 | Panic disorder in adults | 3.0 |
240 | Adrenocortical carcinoma | 3.0 |
241 | Primary ciliary dyskinesia | 3.0 |
242 | Kartagener syndrome | 3.0 |
243 | Umbilical hernia | 3.0 |
244 | Non-alcoholic Fatty Liver Disease | 2.0 |
245 | Renal and perinephric abscess | 2.0 |
246 | Migraine | 2.0 |
247 | Multiple Myeloma | 2.0 |
248 | Inflammatory Bowel Diseases | 1.0 |
249 | Hemorrhagic stroke | 1.0 |
250 | Ischemic stroke | 1.0 |
251 | Acute Bronchitis | 1.0 |
252 | Granulomatosis with polyangiitis | 1.0 |
253 | Chlamydia pneumoniae infection | 1.0 |
254 | endocarditis | 1.0 |
255 | Gallbladder Dyskinesia | 0.0 |
256 | biliary SOD | 0.0 |
257 | Motion Sickness | 0.0 |
258 | Recurrent aphthous stomatitis | 0.0 |
259 | Anemia of chronic disease | 0.0 |
260 | Myasthenia Gravis | 0.0 |
261 | Neonatal Myasthenia Gravis | 0.0 |
262 | Congenital Myasthenic Syndromes | 0.0 |
263 | Insect bites and stings | 0.0 |
264 | Alzheimer disease | 0.0 |
265 | Acute Pancreatitis | 0.0 |
266 | Gallstone pancreatitis | 0.0 |
267 | Acute pyelonephritis in adults | 0.0 |