PMC10210831_01
Diffuse ulceration and friability in the rectum and sigmoid colon.
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fig1
Extensive erythema, friability, and shallow ulcerations were noted extending from the anus up to 22 cm, at which point the procedure was aborted due to significant inflammation and the inability to traverse the rectum (Figures 1(a) and 1(b)).
Rectal mucosa with chronic active inflammation with plasma cells and neutrophilic crypts consistent with Crohn's disease, 200x.
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fig2
Subsequent pathology showed chronic and active colitis with plasma cells and crypts full of neutrophils, consistent with a definitive diagnosis of Crohn's disease (Figure 2).
Duodenal bulb, 2nd portion of the duodenum, and gastric antrum with multiple erosions and ulcerations.
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fig3
Esophagogastroduodenoscopy showed multiple nonbleeding, round, clean-based, and shallow ulcers ranging between 3-7 mm in the duodenal bulb and the 1st and 2nd parts of the duodenum (Figures 3(a)-3(c)).
Duodenal mucosa with active erosive chronic duodenitis, villous blunting and surface epithelium replaced by neutrophils consistent with duodenal Crohn's disease, 200x.
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fig4
Pathology showed fragments of duodenal mucosa with focal ulceration and acute inflammation with surface epithelium replaced by neutrophils and plasma cells, as well as moderately chronic, focally active gastritis with negative H pylori, establishing a diagnosis of gastroduodenal Crohn's disease (Figure 4).