Presentation
Long-standing Crohn disease. Rising calprotectin levels warranted investigation with ultrasound to evaluate for active disease.
Patient Data
Submucosal fat deposition (measured here with callipers) in the terminal ileum in keeping with chronic Crohn disease. No evidence of superadded active inflammation.
Case Discussion
Submucosal fat deposition can result from a variety of causes, such as chronic inflammatory bowel disease (ulcerative colitis and Crohn disease); post-chemotherapy and post-radiotherapy, coeliac disease and now more commonly in obese patients (in particular with accompanying metabolic syndrome and insulin resistance).
In a case of known Crohn disease, the appearance of submucosal fat deposition is a feature of chronic disease.