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We present the case of a 26 year old male patient diagnosed with ileocolonic Crohn’s disease at age 15 years, with a history of several episodes of perianal inflammation that required surgical debridement. In 2000, he was hospitalised for tibiomaleolar oedema that had appeared progressively over the previous four months, associated with clinical signs of perianal inflammation and anal pain after defecating.
Physical exploration revealed a patient who was generally well, with a cushingoid appearance, pallor of skin and mucosae, oedema with fovea in both lower extremities up to the knee, minimum (not painful) fullness of the lower right quadrant and, on anal exploration, three uncomplicated “strings” with a suppurating point adjacent to one of them.
Laboratory tests showed 17 720×106 leucocytes (11 600 neutrophils), haemoglobin 9.8 …
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