Presentation
Marked recurrent right lower abdominal and pelvic pain, associated with nausea and mild weight loss.
Patient Data
Marked circumferential thickening of the distal 25 cm of the small bowel encroaching on its lumen (string sign), showing prominent surrounding mesenteric vessels (comb sign) as well as a minimal fluid smear in-between loops with mild proximal bowel loops dilatation.
Case Discussion
Typical findings of active inflammatory Crohn disease of the distal ileum with marked mural thickening, the "comb sign" of mesenteric congestion and mild proximal small bowel dilatation.
Biopsies confirmed small bowel Crohn disease in this case.