Resources

Title Type
Abdominal striae in a 14 year old Crohn’s disease patient due to steroid use
Active small bowel Crohn’s disease with an associated abscess adjacent to iliostomy
Adenocarcinoma arising in a chronic entero-enteric fistula
Anal fissure
Anastomotic structuring due to recurrent Crohn’s disease
Aphthous ulceration associated with mild colonic Crohn’s disease
Arthritis in a patient with IBD

Image of arthritis in feet of patients with IBD

Axial CT showing complex penetrating Crohn’s disease with an intra-abdominal abscess

Axial CT demonstrates complex penetrating Crohn’s disease with an intra-abdominal abscess (arrowhead)

Axial HASTE image shows thickened ileum with surrounding fat hypertrophy

Axial HASTE image shows thickened ileum (red arrow) with surrounding fat hypertrophy ( yellow arrow)

Axial TRUFISP shows severely thickened small bowel loops with a skip segment

Axial TRUFISP shows severely thickened small bowel loops ( yellow arrows) with a skip segment ( red arrow) which demonstrates mild functional holdup

Capsule endoscopic view of stenosing small bowel Crohn’s disease
Capsule endoscopic views of small bowel Crohn’s disease
Capsule for capsule endoscopy
Colonoscope
Contrast study demonstrating a recto-vaginal fistula
Coronal fat saturated Haste image from an MRCP shows irregularity of intrahepatic ducts
Coronal TRUFISP image showing thickened caecal pole and terminal ileum

Arrow highlights thickened caecal pole and terminal ileum. 

Coronal TRUFISP images indicate thickened segments of bowel

Coronal TRUFISP images indicate thickened segments of bowel (yellow arrows) with an intervening normal segment of bowel ( red arrow)

Coronal TRUFISP showing moderate wall thickening of the terminal and distal ileum secondary to Crohn’s disease

Coronal TRUFISP showing moderate wall thickening of the terminal and distal ileum secondary to Crohn’s disease

Deep ulceration in severe Crohn’s colitis
Diagnosis of tuberculosis
Diagram showing different types of colectomy

Diagram showing different kinds of colectomies

Diagram showing resections in the rectum or anus
Dilatation of small bowel proximal to a thickened slightly strictured distal segment of ileum

Yellow arrow shows dilatation of small bowel proximal to a thickened slightly strictured distal segment of ileum ( red arrow)

Discontinuous ulceration in Crohn’s colitis
Double balloon enteroscopy (scope image)
Double balloon enteroscopy technique
Endoscopy suite
Episcleritis

Image of episcleritis

Erythema nodosum in Crohn’s disease

Image of erythema nodosum in Crohn’s disease patient

Gastroscope
High signal at the site of a complex trans-sphincteric fistula; with resolution after 4 months anti-TNF
Image from Coronal Fat suppressed HASTE sequence of MRCP showing normal bile ducts
Infliximab
Jejunal Crohn’s disease
Laparoscopic assisted panproctocolectomy
Longstanding untreated Crohn’s colitis resulted in pseudopolyposis

Surveillance biopsies demonstrated high grade dysplasia. The colectomy specimen contained a Duke’s A cancer.

Moderate ileocaecal Crohn's disease
Moderate sigmoid colon ulceration
Moderate to severe caecal Crohn’s disease
MR enterography showing terminal ileal thickening and fat hypertrophy

Yellow arrow shows thickened wall fat hypertrophy

MRI showing enterocutaneous fistula with locule of gas

MRI showing enterocutaneous fistula (red arrow) together with locule of gas (yellow arrow)

Mucosal hyperenhancement of distal ileal loops consistent with active disease

Mucosal hyperenhancement of distal ileal loops consistent with active disease

Multiple discharging external fistula opening with seton in situ
Multiple stricturoplasties in a patient with fibrotic small bowel Crohn’s disease
Oedema and ulcerations produce a mucosal cobblestone appearance
Oral ulceration in Crohn’s disease

Image of oral ulceration in Crohn’s disease patient

Parks Classification
Patient infusion of infliximab
Patient self-injection using adalimumab (Humira) pen
Perianal Crohn’s disease persisting following proctectomy
Perianal Crohn’s disease with seton to allow drainage
Perianal disease with drainage seton
Perianal excoriation due to recurrent leakage of faecal matter in a patient with Crohn’s disease
Perianal ulceration with sepsis, fistula & severe inflammation

Perianal ulceration can cause multiple problems for the surgeon and gastroenterologist.  Images show a 20 year old female who first presented with sepsis and na anorectal fistula with severe anal inflammation.  Sepsis was drained by many procedures, and some healing achieved with the aid of biological agents. 

Peristomal pyoderma

Image of peristomal pyoderma

Pyoderma gangrenosum

Image of pyoderma gangrenosum

Rectal Crohn’s disease seen on scope retroflexion
Rectal stricture due to Crohn’s disease
Rectal stricture due to Crohn’s disease
Risk of radiation exposure
Rutgeerts i1 ileitis
Rutgeerts i2 ileitis
Rutgeerts i3 ileitis
Rutgeerts i4 ileitis
Severe Crohn’s colitis
Severe Crohn’s colitis (note relative rectal sparring)
Severe ileocaecal Crohn's disease
Severe perianal Crohn's disease
Severe thickening of the proximal and distal sigmoid colon

Red arrows show severe thickening of the proximal and distal sigmoid colon. Note a normal intervening segment which is markedly dilated

Shingles (Varicella zoster reactivation) associated with anti-TNF
Small bowel stricture with extensive proximal small bowel dilatation

Small bowel stricture (arrow) with very low T2 MR signal characteristic of fibrosis, with extensive proximal small bowel dilatation containing food residue.

Stricturing ileal Crohn’s disease (Contrast CT)

Contrast CT showing a short segmental strictures of the ileum with multiple dilated small bowel loops and air-fluid levels, signifying an obstructive element. The involved segments shows increased mural enhancement suggestive of inflammation.  

T1 fat saturated image post contrast shows mucosal hyperenhancment of the caecum and terminal ileum consistent with active inflammation

T1 fat saturated image post contrast shows mucosal hyperenhancment of the caecum and terminal ileum consistent with active inflammation

Thickened distal ileal loop with surrounding fat hypertrophy

Red arrow indicates thickened distal ileal loop with surrounding fat hypertrophy

Thickened distal ileum with entero-enteric fistulae

Thickened distal ileum with entero-enteric fistulae (yellow arrow)

Thickened strictured segment of ascending colon

Red arrow indicates a thickened strictured segment of ascending colon

Through the scope (TTS) balloon dilatation of an ileo-caecal anastomsis in a patient with Crohn’s disease
Trans-abdominal ultrasound
Transverse colonic aphthous ulceration in a patient with mild Crohn’s colitis
Upper GI endoscopy

Histology: "...extensive ulceration, moderate active chronic inflammation…regenerative changes"

Uveitis

Three images of uveitis

Terms and conditions

By using this site you acknowledge that the content of this website is based on a review process of the ECCO Consensus Guidelines and primarily aims at facilitating their visualization.

Any treatment decisions are a matter for individual clinicians and may not be based primarily on the e-Guide content.

The European Crohn's and Colitis Organisation and/or any of its staff members and/or any website contributor may not be held liable for any information published in good faith on this website.

You agree that the use of this website is at your own risk and hereby waive any and all potential claims against European Crohn's and Colitis Organisation, and/or any of its staff members and/or any of the website contributors.