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Crohn's Disease Forum » Tests for IBD » Things got weird


05-26-2014, 06:58 AM   #1
skyarhale
 
Join Date: Dec 2013
Things got weird

So i went to the ER yesterday because i just couldnt take the pain anymore. They did some blood work, a CAT scan and a ultra sound of my pelvic area. i ended up rupturing a ovarian cyst, but whats weird is the doc said the CAT scan shows no crohns... but the GI doctor who diagnoised me with crohns , did a biopsy and it came back positive for crohns. Any idea as to why thr cat scan doesnt show crohns but the biopsy does ?
05-26-2014, 07:12 AM   #2
gemling
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Skyarhale, are you on any medication for your Crohn's? It could be that you are in remission and therefore not showing any inflammation or physical manifestation at the moment, even though it's still there.

How long ago was your biopsy done? It's still possible to have Crohn's without showing damage.
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Jul 2014 Blockage caused by flare up
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Mid-Sept 2014 Another blockage
Oct 2014 Started Infliximab


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05-26-2014, 07:17 AM   #3
DustyKat
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A CT being an image only and depending on what is going on around the area of your Crohnís, features may be missed or misinterpreted, especially as you get down into the pelvic area.

A biopsy being a piece of tissue can be examined in minute detail, can be tested for various organisms and landmarks searched for that give it the characteristics of Crohnís. You can never get this level of detail via imaging.

Dusty. xxx
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05-26-2014, 07:18 AM   #4
skyarhale
 
Join Date: Dec 2013
The biospy was done in January. The thing is im still having what feels like flare ups. Yes i am on medication but i just started may 12. I guess it doesnt feel like its in remission. Unless the rupture is causing this but it hurts when i eat, that has nothing to do with my overy...
05-26-2014, 07:20 AM   #5
skyarhale
 
Join Date: Dec 2013
Dusty, thats what i thought to. I told the doc i had a biopsy that said i have crohns and he still said no i dont. I trust the GI doc over the ER doc , im just confused
05-26-2014, 07:26 AM   #6
gemling
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I think it's difficult sometimes because the ER doc will have an overarching view of most aspects of medicine, but won't necessarily know all the ins and outs that a specialist would.

Certainly an ovarian cyst could cause you a lot of pain, but since you've only been on meds for a small amount of time, I don't think you'd be in remission quite yet. But as Dusty said, a CT scan might not necessarily show everything in detail. Especially if it's focusing on your pelvis.

I would probably give your GI doctor a call tomorrow and see if you can speak to them. If you are still in the hospital you might be able to see if you can convince the ER doc to have a specialist come to you (or have your GI docs office call to request it?).
05-26-2014, 07:48 AM   #7
DustyKat
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Dusty, thats what i thought to. I told the doc i had a biopsy that said i have crohns and he still said no i dont. I trust the GI doc over the ER doc , im just confused
I would not go with what he ER doc is saying for 3 reasons:

1. He is not a GI.

2. How many cases of Crohnís has he diagnosed.

3. Crohnís is not diagnosed via a simple CT or any CT for that matter.

Case in point 1: My daughter was undiagnosed and one week prior to emergency surgery she has a CT scan. The results came back as grossly normal. One week later she was in theatre with a ruptured and infarcted bowel, pus everywhere and her bowel in tatters. That degree of damage did not happen in one week.

Case in point 2: My son was admitted to hospital with a flare. The CT indicated that it was a massive flare involving most of his small bowel and was one of the reasons that led to quite a lengthy hospital stay and dictated his pre op care. As it was he required surgery due to an abscess and fistula. When they opened him up what they were seeing on the CT wasnít extensive inflammation of the bowel but rather a phlegmon attached to the abdominal wall.

As you can see, CTís have their limitations.

Dusty. xxx
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