Man with abdominal pain.
Review the image below. Which choice best depicts the abnormal structure, if any?
Gallbladder.Portal venous system.Small bowel.Mesentery.Peritoneum.
Axial Image 1: Long segment stenosis of the distal pelvic ileum, inflammation of the terminal ileum at the ileocecal valve. Prominent vasculature, mucosal enhancement
Axial Image 2: Comb sign, dense vessels in the RLQ, feeding active inflammation in distal ileum
Axial Image 3: Small bowel target (double halo) sign in RLQ. Also a fibrostenotic lesion right of midline seen just anterior/medial to external iliac artery, showing enhanced wall, narrowing, with near occlusion of lumen, .
Axial Image 4: Dilated small bowel with stenotic transition point right lower quadrant with mild mesenteric inflammation.
Key points - Crohn's disease: