How common are bowel strictures in Crohn disease?
Around 25% of patients will have a small bowel stricture, and around 10% of patients will have a large bowel stricture.
There is small bowel dilatation and multiple air fluid levels with a transition point in the right iliac fossa in keeping with mechanical small bowel obstruction. The terminal ileum beyond this transition point is stenotic, with wall thickening and adjacent fat stranding in keeping with terminal ileitis. Small bowel just proximal to the transition point contains faeces (small bowel faeces sign) confirming mechanical obstruction. The large bowel is collapsed. No other small bowel lesion is identified. Small amount of free fluid scattered throughout the abdomen and pelvis. No free gas.
Solid organs are normal. No lymphadenopathy. Lung bases are clear. No bony abnormality. No sacroiliitis.
Conclusion
Distal mechanical small bowel obstruction due to terminal ileitis and stricture, in a patient with known Crohn's disease.