Crohn's terminal ileitis and sacroiliitis

Case contributed by Andrew Dixon

Presentation

48 hours of abdominal pain and vomiting

Patient Data

Age: 40 years
Gender: Male

CT Abdomen

ct

Greater than 30 cm contiguous segment of terminal ileitis with luminal narrowing mural thickening and mesenteric venous dilatation (known as the comb sign). There is dilatation of the more proximal small bowel consistent with a degree of obstruction. 

In addition there is right sacroiliitis with partial ankylosis. 

Annotated image

Thickened terminal ileum (blue arrows) is associated with prominence of the mesenteric vessels (yellow arrows) known as the 'comb sign'. The sacroiliac joint on the right is mostly ankylosed (green arrow). 

Case Discussion

This case illustrates appearance consistent with active terminal ileal Crohn's disease with enteropathy associated sacroiliitis.

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