Crohn disease - skip lesion

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Abdominal pain.

Patient Data

Age: 15-20 years
Gender: Female
mri

Terminal ileum wall thickening and hyperenhancement with borderline upstream dilatation measuring up to 3.0 cm. Distal ileum skip lesion 5 cm proximally.  This skip lesion has an enhancing track to the uterine fundus. No definite fistula or abscess is identified. Trace pelvic free fluid is non-specific, possibly physiological.

No biliary dilatation. Visualized upper abdominal viscera demonstrates no gross abnormality. No enlarged upper abdominal lymph nodes.

Mild lumbar scoliosis, convex to the right. No sacroiliitis.

Case Discussion

Typical appearances for Crohn disease with terminal ileitis, skip lesion, and a sinus tract but without fistula abscess formation. 

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