Crohn's disease (with comb sign)

Case contributed by Dr Hanisalam

Presentation

Abdominal pain and weight loss.

Patient Data

Age: 30
Gender: Male
Modality: CT

There is a long segment of distal small bowel thickening along with engorgement of the adjacent mesenteric vessels. 

Around the level of umbilicus, midline anteriorly and just deep to the recti muscles, there is a peripherally enhancing collection containing gas locules, surrounded by inflammatory stranding. 

Colon is unremarkable. Upper abdominal solid viscera look normal. No retroperitoneal lymph node enlargement. Incidental GB stones. No features of acute cholecystitis. 

Interpretation: Features are highly suspecious of inflammatory bowl disease (Crohn's) complicated by intra-abdominal abscess. 

Modality: Ultrasound

Oval hypoechoic abnormality anteriorly in the abdomen, surrounded by an area of hyperaemia. Representing abscess. 

GB stones again noted. 

Case Discussion

Crohn's disease complicated by intraabdominal abscess.

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Case Information

rID: 19874
Case created: 18th Oct 2012
Last edited: 2nd Sep 2015
Inclusion in quiz mode: Included

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