case_images: PMC9043287_01
case_images: (A) Double balloon enteroscopy showed severe mucosal congestion and luminal stenosis with two deep 1.2-1.5 cm-long longitudinal ulcers in the terminal ileum. (B) Computed tomography enterography showed a thickened pelvic ileum wall with adherence, and an intestinal fistula was suspected. (C) The thickened wall, luminal stricture, and fistula were seen in the resected terminal ileum. (D) Histological examination revealed multiple focal congestion, irregular crypts, and pylorus gland metaplasia, and recanalization was observed in some stenotic veins. (E) The wall of the medium-caliber mesenteric veins was thickened with proliferated smooth muscle and a narrow lumen.
case_images: fmed-09-855335-g001.jpg
case_images: PMC9043287_01_fmed-09-855335-g001.jpg
case_images: F1
case_images: On double-balloon enteroscopy, severe mucosal congestion and luminal stenosis were seen with two deep 1.2-1.5 cm-long longitudinal ulcers in the terminal ileum (Figure 1A). CT enterography revealed a thickened pelvic ileum wall with adherence, and an intestinal fistula was suspected (Figure 1B). Two segments of lesions were found with a thickened wall, luminal stricture, and fistula formation in the resected terminal ileum 5 and 20 cm proximal to the cecum (Figure 1C). Multiple focal congestion, irregular crypts, and pylorus gland metaplasia were observed without obvious full-thickness inflammation (Figure 1D). Recanalization was observed in some stenotic veins (Figure 1E).