Enteritis with small bowel intussusceptions

Case contributed by Dr Henry Knipe

Presentation

Abdominal pain, night sweats. CRP 150 ?intra-abdominal abscess.

Patient Data

Age: 20 years
Gender: Male

Three small bowel intussusceptions are seen involving both the ileum and jejunum. The largest measures 3 cm in the jejunum. No small bowel dilatation. The terminal ileum is collapsed but appears thick walled and hyperenhancing. Normal appendix. The sigmoid is collapsed but overall the colon is unremarkable. Moderate volume of low-density pelvic free fluid. No free gas. Multiple ileocolic lymph nodes are prominent but not enlarged beyond 10 mm in short axis.

Case Discussion

Terminal ileitis with further short segment small bowel intussusceptions without obstruction. Inflammatory causes (e.g. Crohn's disease) was thought to be more likely than an infectious cause, however, the patient has been symptom free with normal endoscopy supporting the latter as the most likely cause.
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Case information

rID: 56789
Case created: 22nd Nov 2017
Last edited: 5th Dec 2017
Inclusion in quiz mode: Included

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