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Inflammatory Bowel Disease (cont.)

Multimedia

Media file 1: Stricture, terminal ileum - colonoscopy. Narrowed segment visible upon intubation of the lower small intestine with colonoscope. Relatively little active inflammation is present, indicating this is a cicatrix (scar) stricture.

Media type: Photo

Media file 2: Enteroenteric (bowel-to-bowel) fistula - small bowel series x-ray films. The narrow-appearing segments filled out relatively normally on subsequent films. Note that barium is just starting to enter the cecum in the right lower quadrant (reader's left), but that barium has also started to enter the sigmoid colon toward the bottom of the picture, thus indicating the presence of a fistula (hole) from small bowel to sigmoid colon.

Media type: X-RAY

Media file 3: Severe advanced pyoderma gangrenosum (a rare skin complication of inflammatory bowel disease) is present on the left ankle.

Media type: Photo

Media file 4: Severe colitis - colonoscopy. The mucosa is grossly denuded, with active bleeding noted. This patient had her colon resected very shortly after this view was obtained.

Media type: Photo

Media file 5: Toxic megacolon, a rare complication of ulcerative colitis that almost always requires surgical removal of the colon. Courtesy of Dr Pauline Chu.

Media type: X-RAY

Media file 6: Episcleritis, inflammation of a portion of the eye in conjunction with inflammatory bowel disease. Courtesy of Dr David Sevel.

Media type: Photo

Media file 7: Double-contrast barium enema examination in Crohn colitis demonstrates numerous aphthous ulcers (the tiny spots on the lining of the intestine).