Presentation
Work up for chronic abdominal pain and diarrhea.
Patient Data
Age: 70 years
Gender: Female
From the case:
Crohn disease
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Circumferential increased wall thickness is present at the distal ileal loops, accompanied by surrounding fat stranding, small bowel mesenteric vascular engorgement and several enlarged mesenteric lymph nodes with SAD less than 12 mm.
A 35 mm diverticulum is present in the medial aspect of the second portion of the duodenum.
Degenerative changes such as osteophytosis are seen in the lumbar spine.
Case Discussion
Pathology-proven Crohn disease with involvement of the distal ileum.
Bowel wall thickening, which is most frequently seen in the terminal ileum present in up to 83% of Crohn patients and may be accompanied by a comb sign that refers to engorgement of the vasa recta.
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