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Findings: Abdominal film reveals a featureless, reduced caliber of the descending colon. There is focal colonic wall thickening. The remainder of the bowel is unremarkable.

Diagnosis::Crohn's Colitis.

Discussion: A colonoscopy on the above patient revealed Crohn's Colitis. The terminal ileum was not visualized during the examination. A normal upper gastrointestinal study confirmed that the disease was localized in the colon.

Crohn's is an inflammatory bowel disease. Distribution is typically discontinuous along the gastointestinal axis. Patterns of involvement and the approximate frequency in childhood are as follows: ileocolitis 40%-55%; isolated small bowel 35%-50%; isolated colon 10%. Crohn's is usually concentrated in the right colon. Rectal disease is present in approximately 33% of the patients.

The basic pathologic processes include mild edema and inflammation. In the colon haustral thickening, mild mucosal fold thickening and hazy or slightly irregular bowel margin may be seen. Additionally, thrumbprinting may be seen.

References:
Hilton and Edwards, Practical Pediatric Radiology, Pg. 271-273.

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