What is the most likely diagnosis in the patient shown below?
a. Sprue
b. Scleroderma
c. Crohn's disease
d. Carcinoma of the colon
e. Duodenal hematoma
The Correct Answer: in 28April 10
Crohn's disease
Explanation
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There is a long segment of terminal ileum which is narrowed with irregular margins. There are several ulcers or sacculations present. The location and appearance of this narrowed segment is characteristic of Crohn's Disease. This long narrowed segment would qualify as the "string-sign" of peristent spasm seen with that disease. Crohn's most often affects the terminal ileum and has a bimodal age distribution. Surgery is usually avoided because of the propensity for recurrence at the site of the neo-terminal ileum.