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.
Describe and interpret these scans
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.
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.
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]