Crohn disease

Case contributed by Laughlin Dawes
Diagnosis almost certain

Crohn's disease with prominent involvement of the duodenum.

Case Discussion

Crohn’s disease is a chronic, relapsing and remitting inflammatory disease of the gastrointestinal tract, affecting any site from mouth to anus. The disease is characterized by segmental transmural inflammation, or ‘skip lesions’.

Patients experience abdominal pain, cramping and diarrhea.

Radiographic features include:

  • thickened folds (edema)
  • string sign (tubular narrowing due to spasm or stricture depending on chronicity)
  • mucosal ulcers (aphthous ulcers or deeper transmural ulcers)
  • sinus tracts and fistulae
  • inflammation of surrounding mesentery (creeping fat) with possible abscess formation
  • partial obstruction (bowel wall edema and luminal narrowing or scarring causing fibrostenotic strictures)

Credit: Dr Marina-Portia Anthony.

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