Confirmed case of severe proctitis and peri-anal disease. A prior MRI confirmed perianal inflammation; an ultrasound was performed to look for current active inflammation (i.e. hyperemia on color doppler ultrasound).

Subsequent endoscopy performed a few weeks later with colonic biopsies taken. Histopathology demonstrated active and chronic inflammation with occasional granuloma which was thought to represent inflammatory bowel disease - in particular Crohn disease.