Fistulizing Crohn disease

Case contributed by Michael P. Hartung
Diagnosis almost certain

Presentation

Abdominal discomfort.

Patient Data

Gender: Male
ct
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
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Info

Mildly dilated fluid-filled mid through distal small bowel loops. Thickening and irregularity of the distal and terminal ileum, with branching channels connecting adjacent ileal loops and the sigmoid colon (with mildly thickened wall) in the right lower quadrant. No fluid collections. 

Case Discussion

Crohn disease complicated by enteroenteric and enterocolonic fistulas in the right lower quadrant, with several arborizing tracts associated with thickened and enhancing distal ileal loops. Likely some degree of partial obstruction given the extent of upstream dilation. 

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