case_images: PMC6900620_01
case_images: Endoscopy of the terminal ileum. (a) The black arrows show multiple ulcers
  with regular borders on edematous mucosa seen in the terminal ileum of the
  patient. (b) The blue arrows show edematous erythematous mucosa with
  nodularity in patient's terminal ileum. (c) Endoscopy of healthy terminal
  ileum from another patient being shown for comparison.
case_images: 10.1177_2050313X19893580-fig1.jpg
case_images: PMC6900620_01_10.1177_2050313X19893580-fig1.jpg
case_images: fig1-2050313X19893580
case_images: The patient underwent an elective colonoscopy for colorectal cancer screening in February 2019, which revealed inflammation and multiple ulcers in the terminal ileum, suggestive of CD with a normal-appearing colon (Figure 1).
case_images: Histopthology of the ileal mucosa biopsy. (a) Histopathology of the ileal
  mucosa demonstrates there is preservation of the crypt architecture with the
  presence of mucin depletion and reactive epithelial changes. The lamina
  propria contains increased numbers of inflammatory cells (lymphocytes and
  plasma cells) as shown by the blue arrows. (b) On higher magnification,
  neutrophils are seen superficially with superficial cryptitis (neutrophils
  infiltrating the crypt epithelium) without crypt abscesses and active
  inflammation as shown by the black arrows.
case_images: 10.1177_2050313X19893580-fig2.jpg
case_images: PMC6900620_01_10.1177_2050313X19893580-fig2.jpg
case_images: fig2-2050313X19893580
case_images: Terminal ileum biopsies revealed chronic active ileitis, which is seen in CD; however, there were no granulomas, no crypt abscesses and no evidence of dysplasia or malignancy (Figure 2).