PMC8492294_01
Axial CT image with IV contrast demonstrating inflammatory changes of the distal ileum. The bowel wall is thickened and edematous with surrounding fat stranding.
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Computerized tomography of the abdomen and pelvis with IV and oral contrast demonstrated distal small bowel with severe wall edema, hyperemia, and thickening with marked surrounding inflammation, causing more proximal small bowel dilation and loops of sigmoid closely approximated with distal ileal loops setting the stage for fistulous formation and noninflamed diverticulosis in the distal colon (Figures 1 and 2).
Coronal CT image with IV contrast demonstrating inflammatory changes of the terminal ileum which has a thickened wall.
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fig2
Computerized tomography of the abdomen and pelvis with IV and oral contrast demonstrated distal small bowel with severe wall edema, hyperemia, and thickening with marked surrounding inflammation, causing more proximal small bowel dilation and loops of sigmoid closely approximated with distal ileal loops setting the stage for fistulous formation and noninflamed diverticulosis in the distal colon (Figures 1 and 2).
Axial CT enterography image of the lower abdomen shows persistent inflammation of a short segment of the distal ileum. This segment of the ileal wall is thickened and edematous with minimal surrounding edema.
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fig3
Computerized tomography enterography performed shortly after admission revealed sigmoid colon diverticulitis with a contained serpiginous air and fluid collection measuring 2.9 x 0.7 cm, which extends from the sigmoid colon's surface courses along the distal ileum, with improved distal ileal inflammation (Figures 3 and 4).
Coronal CT enterography image of the lower abdomen demonstrates a sinus tract adjacent to the extraluminal collection which bridges an air-filled sigmoid diverticulum and the adjacent distal ileal loop.
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fig4
Computerized tomography enterography performed shortly after admission revealed sigmoid colon diverticulitis with a contained serpiginous air and fluid collection measuring 2.9 x 0.7 cm, which extends from the sigmoid colon's surface courses along the distal ileum, with improved distal ileal inflammation (Figures 3 and 4).
Sigmoid colon showing mild diverticulosis.
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fig5
He was discharged on ampicillin/sulbactam to complete a 14-day course of antibiotics, to stop secukinumab, and to follow-up after four weeks for a colonoscopy which showed diverticulosis of the sigmoid colon (Figure 5) and no evidence of Crohn's disease.