Ultrasound Case 040

Presentation

A 22 year old man presents with abdominal pain and diarrhoea. He has 3 months of intermittent diarrhoea sometimes with blood, accompanied with weight loss and abdominal discomfort.

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Describe and interpret these scans

IMAGE INTERPRETATION

Image 1: Left iliac fossa, transducer aligned along descending colon. There is a segment of thickened aperistaltic bowel wall with thickness of 6mm (normal ≤3mm). There is loss of the normal haustra coli.

Image 2: Addition of Colour Doppler. There is transmural hypervascularity.

Image 3: There is associated mesenteric lymphadenopathy.

Image 4: Left iliac fossa, transverse view of descending colon.

Image 5: Layers of the bowel wall.

LITFL Top 100 Ultrasound 040 05 Chron's disease Layers of the bowel wall

CLINICAL CORRELATION

Inflammatory bowel disease – Crohn’s disease

Differentiating ulcerative colitis and Crohn’s disease is generally done histologically. However, there are ultrasound features which may guide the clinician toward a favored diagnosis.

Ultrasonographic findings in Crohn's disease. J Ultrasound. 2014
Ultrasonographic findings in Crohn’s disease. J Ultrasound. 2014

Carnevale Maffè G, Brunetti L, Formagnana P, Corazza GR. Ultrasonographic findings in Crohn’s disease. J Ultrasound. 2014 May 24;18(1):37-49. [PMC4353828]


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An Emergency physician based in Perth, Western Australia. Professionally my passion lies in integrating advanced diagnostic and procedural ultrasound into clinical assessment and management of the undifferentiated patient. Sharing hard fought knowledge with innovative educational techniques to ensure knowledge translation and dissemination is my goal. Family, wild coastlines, native forests, and tinkering in the shed fills the rest of my contented time. | SonoCPDUltrasound library | Top 100 | @thesonocave |

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