Symptoms of regional enteritis are variable, its onset is most often insidious, and the history of lower abdominal pain, diarrhea, fever, loss of weight, anemia, abscesses, and fistulas usually extends over months or years. The sequence of routine diagnostic procedures should include scout roentgenograms, febrile blood agglutination studies, warm stool examinations, proctosigmoidoscopic and roentgenologic examinations of the colon. In the absence of obstruction, it is important to give barium by mouth for interval roentgenologic studies of the small intestine. The typical finding in terminal ileitis, the "string sign," is often seen when barium given by enema regurgitates through the ileocolic junction into a stenotic segment of ileum and reveals a dilated segment proximal to the lesion. Sinuses and fistulas may also be revealed. Each patient presents an individual problem. Recurrences after operation are well known, but the mortality is low. Remission with complete healing sometimes occurs, and pessimism as to surgical treatment is unwarranted.
Collins EN. DIAGNOSIS AND CLINICAL COURSE OF REGIONAL ENTERITIS. JAMA. 1957;165(16):2042–2044. doi:10.1001/jama.1957.02980340008002
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