Presentation
Abdominal pain. Known to the gastroenterology clinic.
Patient Data
Age: 40 years
Gender: Male
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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.
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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.