CASE 13983 Published on 05.10.2016

Crohn's disease


Abdominal imaging

Case Type

Clinical Cases


Dr Utkarsh Kabra, Dr Alka Goyal

Getwell Poly-Clinic and Hospital
302004 Jaipur;

37 years, female

Area of Interest Abdomen ; Imaging Technique CT
Clinical History
Chronic abdominal pain and altered bowel habits.
Imaging Findings
Multiple areas of small bowel thickening with intervening skip areas. Few long segment areas of small bowel thickening, mesenteric vascular engorgement with multiple enlarged mesenteric lymph nodes.
In a patient who presents with a chronic history of abdominal pain and altered bowel habits, inflammatory bowel disease should be a consideration.
A CE CT abdomen is the investigation of choice in such cases.

In the above case there were multiple areas of small bowel thickening with skip areas, few long segment small bowel thickenings, mesenteric vascular engorgement and enlarged mesenteric lymph nodes [1].
All these findings favour the diagnosis of inflammatory bowel disease, most likely Crohn's.
The differentials under consideration were ulcerative colitis and tuberculosis.

In ulcerative colitis there is continuous involvement of the bowel without any skip areas starting from the rectum and proceeding proximally.

In tuberculosis there is predominant involvement of the caecum and ileocaecal junction and necrotic, caseous lymphadenopathy. Skip areas and mesenteric vascular engorgement are absent.
Differential Diagnosis List
Crohn's disease
Ulcerative colitis
Final Diagnosis
Crohn's disease
Case information
DOI: 10.1594/EURORAD/CASE.13983
ISSN: 1563-4086