Crohn disease is an idiopathic infl ammatory bowel
disease that can affect any segment of the GI tract
but usually involves the small intestine (terminal
ileum) and colon.
Young adults of northern European ancestry are
more commonly affected.
Transmural edema, follicular lymphocytic
infiltrates, epithelioid cell granulomas, and
fistulation characterize this disease.
Signs and symptoms include the following:
• Diffuse abdominal pain (paraumbilical and
• Dyspareunia (pain during sexual intercourse)
• Urinary tract infection (UTI)
primary volvulus of the small
intestine abrupt dietary changes
Sigmoid volvulus. A. Supine abdominal radiograph showing the
dilated, volvulated segment of redundant sigmoid colon pointing
toward the right upper quadrant; arrows show the space between
the sigmoid and hepatic and splenic flexures. B. Contrast enema in
sigmoid volvulus showing cut off at distal site of volvulated
sigmoid having a "bird-beak" appearance
Cecal volvulus. Dilated volvulated cecum pointing to left upper quadrant. Arrows indicate the cecal tip
Complete small bowel obstruction. A. Supine abdominal radiograph shows multiple loops of dilated small bowel with
colonic gas. B. Upright radiograph shows multiple air-fluid levels in the small intestine (arrows).