Elderly patient presented with chronic abdominal pain.
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Circumferential wall thickening measuring approximately 7-10 mm noted involving the terminal ileum with significant luminal compromise and stricture narrowing of the terminal ileum near ileocecal junction.
There is infiltration of low attenuation material (HU= -40) in the submucosal layer which is non-enhancing. The overlying muscularis propria and undelying mucosa are enhancing well and depicting fat halo sign.
There is surrounding mesenteric fat stranding and fibrofatty proliferation and perivascular inflammatory infiltration outline the distended intestinal arcades, displaying comb sign.
Few enlarged, non-necrotic lymph nodes are noted in the inflamed part of the mesentery.
Imaging features are most likely represent Crohn's disease
Endoscopy and biopsy performed which shows ulcerated mucosal irregularities with submucosal hypertrophy and presence of non-caseous inflammatory granulomas, which is consistent with the diagnosis of Crohn's disease.