Barium study of a 35-year-old Indian male presented with fever, lower abdominal pain, and diarrhea and weight loss of one-year duration. X-ray shows cone shaped, contracted and retracted cecum, which is pulled up towards the right hypochondrium. Fibrotic terminal ileum that empties into a rigid contracted cecum [Steirlin's Sign]. Biopsy from the above lesions showed epithelioid granulomas with caseation necrosis. Acid fast bacilli was not isolated from the lesions, but yield of AFB from GI lesions are low.
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