Answer of July 2001

Clinical History:

M/29. Complained of Right Lower Quadrant Pain

Figure 1-4 Contrast enhanced axial scan of abdomen

What is your diagnosis?

                                  Figure 1                                                                      Figure 2

                                  Figure 3                                                                      Figure 4

Diagnosis:

Crohn's diseas affecting terminal ileum, ascending and transverse colon with intra-abdominal abscess formation.

Discussion:

Figure 1 Axial post-contrast CT scan of abdomen showing abnormal transverse colon.

Figure 2 & 3 Axial scan of abdomen taken at lower level showing similar abnormality affecting the ascending colon as well. There is an abnormal collection medial to the ascending colon. The collection contained both fluid and gas suggested abscess formation.

Figure 4 Further lower section of lower abdomen showing abnormal bowel loops in caecum and terminal ileum.