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 19 June 2018

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GastroenterologyInflammatory bowel disease

Crohn's disease

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Recurrent Crohn's disease of the distal ileum.

A 31-year-old woman with recurrent Crohn's disease of the distal ileum. She had previously undergone a limited right hemicolectomy and a stricturoplasty of an ileal segment of recurrent Crohn's. On this occasion she presented with a twelve-month history of obstructive symptoms and underwent a right hemicolectomy.

In addition to her obstructive symptoms, the patient had several perineal lesions, which intermittently discharged purulent material. No fistulous communication with the gut could be demonstrated. The photograph shows two sinuses either side of the labia. Several anal skin tags are present. Apart from the ileal disease, these lesions were the only other evidence of Crohn's disease present.

One photograph shows the resected specimen, with a short strictured segment between large and small bowel. The mucosa is ulcerated and the submucosal tissues thickened. There is a large ulcer in the colon (to the right of the picture) adjacent to the stricture.
Peter Devitt, Adelaide, Australia

Recurrent Crohn's disease of the distal ileum.

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