Presentation
Presented with perianal discomfort and serological testing showed raised inflammatory markers.
Patient Data
Severe active inflammation of the rectum with hyperemia (shown by color Doppler) with surrounding hyperechoic perirectal fat proliferation. The rectum was hard to appreciate on the longitudinal view however a small volume of pelvic free fluid was noted.
Case Discussion
Confirmed case of severe proctitis and peri-anal disease. A prior MRI confirmed perianal inflammation; an ultrasound was performed to look for current active inflammation (i.e. hyperemia on color doppler ultrasound).
Subsequent endoscopy performed a few weeks later with colonic biopsies taken. Histopathology demonstrated active and chronic inflammation with occasional granuloma which was thought to represent inflammatory bowel disease - in particular Crohn disease.
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