Crohn disease (MR enterography)

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Chronic diarrhoea and recurrent abdominal pain.

Patient Data

Age: 45 years
Gender: Female
  • multifocal segmental mural thickening with dominant mesenteric side involvement in the distal & terminal ileum with some skip segments in between

  • short segment stenosis in the terminal ileum measuring about 3cm in length and extending to the ileocaecal valve with a maximum mural thickness of 9mm & some mural ulcers

  • intense asymmetric enhancement in the involved ileal segment including the stenotic part accompanied by mesenteric engorgement

  • prominent pericentric vasculature giving the "comb sign" and prominent fibrofatty infiltration

  • no evidence of fistula, collection, ascites or obstruction

Case Discussion

MRE imaging findings are in favour of the patient's known Crohn's disease with dominant active patterns in the distal & terminal ileum and short inflammatory strictures at the terminal ileum proximal to the ileocaecal valve.

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