PMC10228216_01
CT showed diffuse colitis.
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C-reactive protein (CRP) level of 3.6 mg/dl. Computed tomography of the abdomen showed diffuse colitis (Figure 1).
Colonoscopy on presentation shows terminal ileum with aphthous ulcerations (a) and scattered ulcerations in the rectosigmoid (b, c).
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The ascending and transverse colon appeared normal, but bleeding ulcerations, exhibiting both fresh and clotted blood, were observed in the descending colon, sigmoid colon, and rectum (Figure 2).
(a) Crypt abscess (active colitis) in the cecal biopsy specimen. (b) Paneth cell metaplasia in rectal biopsy indicating the ongoing inflammatory process.
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Similarly, biopsies obtained from the large bowel and rectum showed evidence of mildly active chronic colitis, with no evidence of dysplasia (Figure 3).
Colonoscopy after 6 months shows normal ileum and colon.
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Six months later, follow-up colonoscopy showed no active inflammation (Figure 4), and the fecal calprotectin level was <5 mcg/g.