Colecistopatia aguda calculosa como manifestação extraintestinal em paciente com doença de Crohn: relato de caso

Luilson Geraldo Coelho Júnior; Brenno Vinicius Porto Lima; Danilo Fossalusa Minari; Marcos Paulo Borges Mendanha; Bernard Moreira Oliveira; Hamilton Alexandre Grosmann Barbosa; Adão Jair de Souza

doi:10.23925/1984-4840.2018v20i2a10

Autores

Luilson Geraldo Coelho Júnior Universidade Federal do Espírito Santo (UFES), Hospital Universitário Cassiano Antonio Moraes (HUCAM) - Vitória (ES), Brasil.
Brenno Vinicius Porto Lima Faculdade Atenas, Medicina – Paracatu (MG), Brasil.
Danilo Fossalusa Minari Hospital Heliópolis – São Paulo (SP), Brasil.
Marcos Paulo Borges Mendanha Universidade de Brasília (UnB), Hospital Universitário de Brasília – Brasília (DF), Brasil.
Bernard Moreira Oliveira Faculdade Atenas, Medicina – Paracatu (MG), Brasil.
Hamilton Alexandre Grosmann Barbosa Faculdade Atenas, Medicina – Paracatu (MG), Brasil.
Adão Jair de Souza Faculdade Atenas, Medicina – Paracatu (MG), Brasil.

DOI:

https://doi.org/10.23925/1984-4840.2018v20i2a10

Palavras-chave:

doenças inflamatórias intestinais, doença de Crohn, colecistite, colelitíase

Resumo

A doença de Crohn (DC) é uma patologia inflamatória intestinal de etiologia desconhecida que acomete o trato gastrointestinal e pode afetar outros órgãos, como, por exemplo, a vesícula biliar. Entre as manifestações hepatobiliares, os pacientes podem apresentar colecistite, colelitíase, colangite. A associação entre DC e colelitíase é bem estabelecida, sendo esses pacientes são mais propensos a desenvolver colelitíase, devido à alteração na composição da bile e a uma redução da motilidade da vesícula biliar. Descrevemos um caso em que uma paciente com doença de Crohn apresentou colelitíase.

Downloads

Não há dados estatísticos.

Metrics

Carregando Métricas ...

Referências

Teixeira, MG. Tratamento cirúrgico da doença de Crohn [tese de livre-docência]. São Paulo: Faculdade de Medicina, Universidade de São Paulo; 2000.

Fiocchi C. Inflammatory bowel disease: etiology and pathogenesis. Gastroenterology. 1998;115(1):182-205. https://doi.org/10.1016/S0016-5085(98)70381-6

Langholz E, Munkholm P, Krasilnikoff PA, Binder V. Inflammatory bowel diseases with onset in childhood. Clinical features, morbidity, and mortality in a regional cohort. Scand J Gastroenterol. 1997;32:139-47. https://doi.org/10.3109/00365529709000184

Kirschner BS. Differences in the management of inflammatory bowel disease in children and adolescents compared to adults. Neth J Med. 1998;53(6):S13-8.

Parente F, Pastore L, Bargiggia S, Cucino C, Greco S, Molteni M, et al. Incidence and risk factors for gallstones in patients with inflammatory bowel disease: a large case-control study Hepatology. 2007;45(5):1267-74. https://doi.org/10.1002/hep.21537

Gizard E, Ford AC, Bronowicki JP, Peyrin-Biroulet L. Systematic review: the epidemiology of the hepatobiliary manifestations in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2014;40(1):3-15. https://doi.org/10.1111/apt.12794

Gisbert JP, Chaparro M, Esteve M. Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2011;33(6):619-33. https://doi.org/10.1111/j.1365-2036.2010.04570.x

Khan N, Abbas AM, Whang N, Balart LA, Bazzano LA, Kelly TN. Incidence of liver toxicity in inflammatory bowel disease patients treated with methotrexate: a meta-analysis of clinical trials. Inflamm Bowel Dis. 2012;18:359-67. https://doi.org/10.1002/ibd.21820

Levine JS, Burakoff R. Extraintestinal manifestations of inflammatory bowel disease. Gastroenterol Hepatol. 2011;7(4):235-41.

Kratzer W, Haenle MM, Mason RA, von Tirpitz C, Kaechele V. Prevalence of cholelithiasis in patients with chronic inflammatory bowel disease. World J Gastroenterol. 2005;11(39):6170-5. https://doi.org/10.3748/wjg.v11.i39.6170

Kangas E, Lehmusto P, Matikainen M. Gallstones in Crohn’s disease. Hepatogastroenterology. 1990;37(1):83-4.

Bargiggia S, Maconi G, Elli M, Molteni P, Ardizzone S, Parente F, et al. Sonographic prevalence of liver steatosis and biliary tract stones in patients with inflammatory bowel disease: study of 511 subjects at a single center. J Clin Gastroenterol. 2003;36(5):417-20.

Hutchinson R, Tyrrell PN, Kumar D, Dunn JA, Li JK, Allan RN. Pathogenesis of gall stones in Crohn’s disease: an alternative explanation. Gut. 1994;35(1):94-7.

Lapidus A, Einarsson C. Bile composition in patients with ileal resection due to Crohn’s disease. Inflamm Bowel Dis. 1998;4(2):89-94. https://doi.org/10.1002/ibd.3780040204

Lapidus A, Einarsson K. Effects of ileal resection on biliary lipids and bile acid composition in patients with Crohn’s disease. Gut. 1991;32(12):1488-91.

Lapidus A, Akerlund JE, Einarsson C. Gallbladder bile composition in patients with Crohn’s disease. World J Gastroenterol. 2006;12(1):70-4. https://doi.org/10.3748/wjg.v12.i1.70

Pereira SP, Bain IM, Kumar D, Dowling RH. Bile composition in inflammatory bowel disease: ileal disease and colectomy, but not colitis, induce lithogenic bile. Aliment Pharmacol Ther. 2003;17(7):923-33. https://doi.org/10.1046/j.1365-2036.2003.01529.x

Rutgeerts P, Ghoos Y, Vantrappen G, Fevery J. Biliary lipid composition in patients with nonoperated Crohn’s disease. Dig Dis Sci. 1986;31(1):27-32.

Brink MA, Slors JFM, Keulemans YCA, Mok KS, De Waart DR, Carey MC, et al. Enterohepatic cycling of bilirubin: a putative mechanism for pigment gallstone formation in ileal Crohn’s disease. Gastroenterology. 1999;116(6):1420-7. https://doi.org/10.1016/S0016-5085(99)70507-X

Parray FQ, Wani ML, Bijli AH, Thakur N, Irshad I, Nayeem-ul-Hassan. Crohn’s disease: a surgeon’s perspective. Saudi J Gastroenterol. 2011;17(1):6-15. https://doi.org/10.4103/1319-3767.74430

Wilkens R, Novak KL, Lebeuf-Taylor E, Wilson SR. Impact of intestinal ultrasound on classification and management of Crohn’s disease patients with inconclusive colonoscopy. Can J Gastroenterol Hepatol. 2015;2016 (Article ID8745972):1-9. https://doi.org/10.1155/2016/8745972