Clinical presentation:
26 year old woman with abdominal pain and loose stool.

This is a late follow through barium examination that has contrast in the colon. It has outlined an abnormality of terminal ileum, caecum and ascending colon. The terminal ileum shows nodular mucosal thickening with fissuring "rose thorn" ulcers penetrating the thickened wall that separates it from the shrunken lumen of the caecum. The caecum and ascending colon show similar changes with extensive "cobblestone" nodular mucosal thickening. The transverse colon is shortened and, like the ascending colon, has lost its haustra. The abnormality extends into the descending colon, although the longitudinal folds in the section at the pelvic brim suggest that this is a contraction wave. (A diagnostic study would always have two views to identify possible peristalsis).