Crohn's disease of the terminal ileum.
A 47-year old woman undergoing a hysterectomy for fibroids. An
incidental finding of an inflammatory mass in the terminal ileum, which was adherent to surrounding structures and appeared to have a fistulous communication with the sigmoid colon. This looked like Crohn's disease. A limited right hemicolectomy and sigmoid colectomy were performed. The diagnosis of Crohn's was confirmed histologically.
On further questioning, the patient did admit to a history of vague Lower abdominal pain.
This operative view shows the caecum pulled laterally by the surgeon, with the appendix on the stretch. There is an area of fat-wrapping and inflammation in the terminal ileum, which is adherent to the adjacent sigmoid colon.
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