ABSTRACT
A 53-year-old lady presented with a 5-day history of diarrhoea and vomiting. She had known Crohn's disease, which was normally well controlled. She was seen in the emergency department and diagnosed with a flare of Crohn's disease. Her observations were stable and she appeared clinically well. She was discharged with a course of oral prednisolone and advised to attend the gastroenterology outpatient clinic. She returned to the emergency department 4 days later, complaining that she was opening her bowels 10 times daily, passing loose, yellow motions with associated abdominal pain. Her past history also included rheumatoid arthritis, atrial fibrillation and hypertension. She was unsure which medications she was taking, aside from methotrexate. She worked as a catering assistant and did not smoke or drink alcohol.
