Diagnosis: Crohn’s disease
Modality: Barium / Fluoroscopy
Findings: Wall thickening of the ileum is seen on follow through of GI series on fluoroscopy. Findings consistent with inflammation of the terminal ileum in Crohn’s disease.
Discussion and Key Points: In the small bowel, in Crohn’s disease, there can be skip lesions and discrete ulcers. The terminal ileum is usually affected first but remaining segments of the small bowel are also commonly affected. On fluoroscopy, on small bowel follow-through, mucosal ulcers can be seen and widely separated bowel loops of bowel can also be seen due to fatty proliferation (“creeping fat”). There can also be the “string sign” seen which is narrowing or spasm of small bowel segments. Look for partial bowel obstructions and also pseudodiverticulum formation.
Credit: Case submitted by Dr. Saeed Rad to radRounds Radiology Network