Crohn's Disease

Crohn’s disease can involve the whole of the gastrointestinal tract from the mouth to the anus — most often the small bowel, the large bowel or both — and can be seen through all the layers of the bowel wall. Its involvement of the bowel is segmental: some areas are diseased while others stay healthy.

In ileal-type Crohn’s disease, ulcers develop in the last part of the small bowel, called the terminal ileum. These add to the patient’s complaints: obstruction of the bowel, the development of fistulas, and abdominal pain that mimics appendicitis. In the first video you are looking at numerous ulcers of varying size, covered with white exudate, inside the lumen of the small bowel at the terminal ileum.

Aphthous lesions are also often met with in the bowel in Crohn’s disease. These are round-looking lesions of the lining, usually 1–3 mm across, white in the middle and red (hyperaemic) around the edge. Besides Crohn’s disease they can appear in Behçet’s disease, with certain viruses, and following the use of some drugs (non-steroidal anti-inflammatory drugs, certain antidepressants). Treatment is directed at the cause. Aphthous lesions can be seen in the second and third videos.