Presentation
Abdominal pain. Known to the gastroenterology clinic.
Patient Data
Small bowel gaseous dilatation and signs of extensive likely bowel surgery in the pelvis. No evidence of gas in the large bowel (procto-colectomy?). No pneumoperitoneum.
Features of proctocolectomy with ileal pouch-anal anastomosis (IPAA) and a short segment of active ileal inflammation with stricture in its afferent loop. Engorged vasa recta. No signs of penetrating disease. The bowel is otherwise unremarkable.
Case Discussion
This patient has a known history of Crohn's disease and has had proctocolectomy with ileal pouch-anal anastomosis many years ago (J-pouch surgery). Features are those of active Crohn's information with stricture.