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Crohn appendicitis

Axial T2 (image 1) and T1-weighted postcontrast (image 2) MRI during MR enterography in a patient with Crohn disease shows mild inflammation of the appendix (arrow). The appendix can be inflamed in patients with Crohn disease. Isolated Crohn appendicitis is rare occurring in less than 1% of patients with Crohn disease. Patient is often present with signs of acute appendicitis.

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AP radiograph (image 1) and focused AP radiograph of the right lower quadrant (image 2) during small bowel follow-through show findings of Crohn disease with affecting the terminal ileum (arrow). The terminal ileum is isolated, has luminal narrowing, and a irregularity of the luminal surface. Crohn disease is an inflammatory bowel disease. It is most commonly diagnosed in the second or 3rd decade of life. The terminal ileum is the most commonly affected segment of bowel although any bowel segment can be affected. Features of Crohn disease include skip lesions, transmural inflammation, and stricturing or penetrating complications.

Oblique axial T2-weighted MRI of the rectum in a patient with Crohn disease shows a fistula (arrow) arising from the 2:00 position of the rectum. There is a small abscess (arrowhead, image 2) in the left medial buttocks. Perianal fistulas develop in approximately a quarter of patients with Crohn disease. They are often best identified on T2-weighted images. Postcontrast images are helpful to identify an abscess.

Longitudinal ultrasound images of the appendix in a child with acute appendicitis shows a dilated tubular appendix. The appendix measures 8 mm in diameter (dashed line, image 1). There is surrounding hyperechoic fat (arrow). A 5 mm fecalith (arrowhead) is present within the appendiceal lumen. During real-time ultrasound the appendix was not compressible. Ultrasound is an excellent modality to identify and diagnose acute appendicitis. Findings include appendiceal diameter greater than 6 mm, surrounding echogenic periappendiceal fat, and a noncompressible appendix. A nonvisualized appendix without secondary signs of appendicitis should be considered to be normal.

inflamed cecum and appendix for appendicitis.

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