Presentation
Abdominal pain. Known to the gastroenterology clinic.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/52831405/a05662bb8d415f1aebd80553f7ebcd_big_gallery.jpeg)
Small bowel gaseous dilatation and signs of extensive likely bowel surgery in the pelvis. No evidence of gas in the large bowel (procto-colectomy?). No pneumoperitoneum.
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![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/52831514/d0ac06098837617621b2ca688f53d0_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/52831580/9d8a9cd0e9aa6e6423b2909ba80e8e_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/52831452/39ff1a0a2a604e7fd58fe8ad30c8a5_big_gallery.jpeg)
Features of proctocolectomy with ileal pouch-anal anastomosis (IPAA) and a short segment of active ileal inflammation with stricture in its afferent loop. Engorged vasa recta. No signs of penetrating disease. The bowel is otherwise unremarkable.
Case Discussion
This patient has a known history of Crohn's disease and has had proctocolectomy with ileal pouch-anal anastomosis many years ago (J-pouch surgery). Features are those of active Crohn's information with stricture.