Case 4. Postoperative recurrence with the development of stricture

 

MRE ASSESSMENT OF STRICTURE INFLAMMATORY ACTIVITY

A 42-year-old patient operated on due to CD four years ago, without having undergone clinical controls. The patient consulted due to repeated abdominal pain and bloating for the past 2-3 months. Laboratory tests: mild ferropenic anemia and increased C-reactive protein levels.

 

Figure 1. Colonoscopy was performed up to the ileocolic anastomosis, which was found to be severe strictured, with thickening of inflammatory appearance and ulceration of the anastomosis. The evaluation proved incomplete, and MRE was therefore carried out to complete the study (References 3 and 4)
 

 

Figure 2. Extensive stricturing was observed, with an important inflammatory component, extending from the area of the anastomosis along the neo-ileum over a distance of approximately 20 cm. Segmental involvement of inflammatory appearance in the terminal ileum.
 

Given the degree of inflammatory involvement of the stricture and the history of surgery, anti-TNF therapy was started.

 

Figure 3. MRE control after three months of treatment. Improvement of inflammatory parameters, with increased motility and luminal caliber in the affected zone.

 
 

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