Patient female, 37 year(s)
患者女性，37歲
CLINICAL HISTORY
臨床病史
Chronic abdominal pain and altered bowel habits.
慢性腹痛及排便習慣改變。
IMAGING FINDINGS
成像發現
Multiple areas of small bowel thickening with intervening skip areas. Few long segment areas of small bowel thickening, mesenteric vascular engorgement with multiple enlarged mesenteric lymph nodes.
小腸多個區域增厚及跳躍區域干預。小腸部分較長的腸段增厚，腸系膜血管充血伴有多發性腸系膜淋巴結腫大。
Figure 1（圖一）
Arrow shows a segmental thickened bowel loop.
箭頭所指表示節段性腸管增厚。
Figure 2 圖二
Arrows show thickened bowel loops.
箭頭所指表示腸管增厚。
Figure 3 圖三
Arrows show thickened bowel loops and enlarged mesenteric lymph nodes.
箭頭所指表示腸管增厚和腸系膜淋巴結腫大。
Figure 4 圖四
Arrows showing enlarged mesenteric lymph nodes.
箭頭所指表示腸系膜淋巴結腫大。
Figure 5 圖五
Arrows show another thickened bowel loop.
箭頭所指表示另一個腸管增厚。
Figure 6 圖六
Large arrows show mesenteric vascular engorgement and the small arrow shows a thickened bowel loop.
大箭頭所指表示腸系膜血管充血，小箭頭表示增厚的腸袢。
Figure 7 圖七
Arrows show long segment thickening of a bowel loop.
箭頭所指表示腸管長節段增厚。
DISCUSSION
討論
In a patient who presents with a chronic history of abdominal pain and altered bowel habits, inflammatory bowel disease should be a consideration.
在一位表現有慢性腹痛病史和排便習慣改變的患者中，應考慮炎性腸炎。
A CE CT abdomen is the investigation of choice in such cases.
在這種案例中，慢性子宮內膜炎（CE）腹部CT可作為一個研究選項。
In the above case there were multiple areas of small bowel thickening with skip areas, few long segment small bowel thickenings, mesenteric vascular engorgement and enlarged mesenteric lymph nodes .
在上文的例子中有小腸多個區域增厚及新生區域干預，小腸部分較長的腸段增厚，腸系膜血管充血伴有多發性腸系膜淋巴結腫大。
All these findings favour the diagnosis of inflammatory bowel disease, most likely Crohn's.The differentials under consideration were ulcerative colitis and tuberculosis.
所有這些發現支持了炎性腸病的診斷，最可能是克羅恩病。不同的觀點有潰瘍性結腸炎和結核病。
In ulcerative colitis there is continuous involvement of the bowel without any skip areas starting from the rectum and proceeding proximally.
在潰瘍性結腸炎中，持續累及小腸但無任何新生區域，開始于直腸和周圍臨近部分。
In tuberculosis there is predominant involvement of the caecum and ileocaecal junction and necrotic, caseous lymphadenopathy. Skip areas and mesenteric vascular engorgement are absent.
在結核病中，明顯累及盲腸與回盲部交接處并有壞死和干酪樣淋巴結病。 不存在新生區域和腸系膜血管充血。
FINAL DIAGNOSIS
最終診斷
Crohn's disease
克羅恩病