investigation

Crohn's disease is a form of inflammatory bowel disease. It commonly affects the terminal ileum and colon but may be seen anywhere from the mouth to anus

Bloods

• C-reactive protein correlates well with disease activity

Endoscopy

• colonoscopy is the investigation of choice
• features suggest of Crohn's include deep ulcers, skip lesions

Histology

• inflammation in all layers from mucosa to serosa
• goblet cells
• granulomas

Small bowel enema

• high sensitivity and specificity for examination of the terminal ileum
• strictures: 'Kantor's string sign'
• proximal bowel dilation
• 'rose thorn' ulcers
• fistulae

Barium study is shown from a patient with worsening Crohn's disease. Long segment of narrowed terminal ileum in a 'string like' configuration in keeping with a long stricture segment. Termed 'Kantor's string sign'.

Management