Long standing gastrointestinal symptoms.
CT abdomen and pelvis
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The colon from anus to the caecum appears thick walled, featureless, with evidence of a prominent fat halo of the recto sigmoid. At the recto sigmoid junction the lumen does gradually tapers suggesting the presence of a stricture. No mass can be identified here or elsewhere along the colon.
The terminal ilium contains a feculent material, is somewhat dilated and also featureless. Numerous enlarged nodes are seen in the perirectal fat, retroperitoneum, and mesentery, all are likely reactive.
The upper abdominal solid viscera are unremarkable, and the gallbladder contains a single intraluminal calcified focus, presumably a gallstone. Note choledocholithiasis.
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This case illustrates advanced features of ulcerative colitis.