PMC5943120_01
A, B, Colonoscopic images showing longitudinal ulcers in the terminal ileum (A) and aphthous erosions in the caecum (B). C, Esophagogastroduodenoscopic image showing of stomach linear erosions in the gastric corpus. D, Histologic picture of the biopsy specimens from the ileal ulcerative lesion reveals dense lymphoplasmacytic infiltrate without any evidence of epithelioid cell granulomas.
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F1
Colonoscopy revealed longitudinal ulcers in the terminal ileum and multiple aphthous erosions in all areas of the colorectal mucosa (Fig. 1A, B). Esophagogastroduodenoscopy (EGD) revealed multiple linear erosions in the gastric corpus (Fig. 1C) and circular erosions in the duodenal second portion. Although none of the biopsy specimens from these erosions, ulcerative lesions and normal-appearing mucosa revealed any evidence of epithelioid cell granulomas (Fig. 1D), we clinically diagnosed the patient as having CD, and intravenous administration of infliximab 5 mg/kg was started.
Colonoscopic images showing healed ulcer scars in terminal ileum (A) and normal-appearing mucosa in the cecum (B).
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F2
Follow-up colonoscopy 6 months later demonstrated that both the longitudinal ulcers in the terminal ileum and aphthous lesions in the colorectum had completely disappeared (Fig. 2A, B).