Case 10: Labs and imaging

He undergoes the following additional workup for his acute worsening of symptoms:​

​

Labs/Stool studies:​

  • CRP 18.7 (High), ESR 42.8 (High), WBC 6.7 (normal)​
  • C-diff: Negative, GI PCR: Negative ​

​

MRE:​

  • 8 cm of terminal ileal thickening consistent with a known diagnosis of Crohn’s disease. No abscess. No stricture noted. ​

Colonoscopy:​

  • Patchy erythema with loss of vascularity throughout the colon, worse in the transverse colon; biopsied. ​
  • Areas of ulceration and edema in the terminal ileum; biopsied. ​( Image below)
  • Pathology: ​Active ileitis with ulceration​ and Chronic,  inactive colitis ​

Terminal ileum; endoscopic appearance Figure source
MR Enterography, terminal ileum

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