Rationale: Crohn disease (CD) is a chronic, relapsing gastrointestinal tract disorder. The incidence of CD is increasing worldwide. Comprehensive nursing care is essential for managing complex treatment regimens and promoting adherence in this population. While biologics and exclusive enteral nutrition (EEN) are established treatments, nursing-led strategies to ensure adherence and manage the transition between these therapies are poorly documented, especially in the home-care setting. Patient concerns: An adolescent patient with a recent history of perianal abscess surgery presented with intermittent abdominal pain, fever, poor wound healing, unformed stool, loss of appetite, and significant weight loss. The patient later developed a suspected enterocutaneous fistula, leading to intensified symptoms and emotional distress. Diagnoses: The patient was diagnosed with CD, accompanied by mild anemia, gastrointestinal dysfunction, intestinal flora imbalance, and nutritional risk. A suspected small intestinal fistula was identified during follow-up. Interventions: Critical nursing care includes biological agent care, nutritional support, pain control, psychological care, skin care, observation and nursing care of fever and pain, and home health guidance. Outcomes: Through nursing interventions, the patient’s clinical condition significantly improved. He achieved clinical remission, evidenced by the resolution of fever and abdominal pain, improved inflammatory markers, and a weight gain of 3 kg. Notably, the patient successfully adhered to the prolonged out-of-hospital EEN and subsequently transitioned back to a normal diet. Lessons: This case highlights the critical role of individualized and sustained nursing care in improving clinical and psychological outcomes in adolescents with complex CD. Integrating advanced biologic treatment with EEN under close nursing supervision proved feasible and effective. These findings support the adoption of a holistic nursing approach that addresses both physical and emotional needs in similar cases. Further research should focus on standardizing integrative nursing protocols for pediatric inflammatory bowel disease.
Wang et al. (Fri,) studied this question.