Crohn disease

Case contributed by Bassem Marghany
Diagnosis certain


Chronic abdominal pain and recurrent diarrhea for 10 years; Previous abdominal surgery 10 months back.

Patient Data

Age: 35 years
Gender: Female

Segmental small bowel wall thickening and post-contrast hyper-enhancement mainly appreciated at the left iliolumbar region, with alternating stenotic and dilated segments of the affected bowel and proliferation of the surrounding fat.

Case Discussion

This patient had a previous bowel segment resection for strictures and obstruction. At laparoscopy, narrowing and thick walls of a segment of mid-small bowel (ileum) about 2 feet long with multiple strictures, cobblestone appearance and fissuring ulcerations, mainly along the mesenteric border, as well as mesenteric fat thickening were noted. No evidence of malignancy. The following histopathology report confirmed the same.

MR enterography is one of the most valuable techniques for evaluation of small bowel disease, particularly Crohn disease.   

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