Involvement of the small bowel by Crohn's disease can be classified using the changes seen on imaging studies. The pattern seen at a specific point is affected by disease activity and therapeutic interventions.
A single bowel segment may show more than one pattern, and adjacent bowel segments may show different patterns.
Ulcerations |
Other Changes Seen |
Subtype |
superficial aphthae |
minimal edema (minimal thickening or distortion of folds) |
active inflammation, minimal |
deep ulcerations, cobblestone mucosa |
marked wall thickening from transmural inflammation; target sign; "comb sign", obstruction secondary to spasm |
active inflammation, severe |
NA |
mild prestenotic dilatation; no mural edema; minimal bowel wall thickening; minimal decrease in luminal diameter |
fibrostenotic, minimal stenosis |
NA |
prestenotic dilatation; marked bowel wall thickening with soft tissue density; marked decrease in luminal diameter |
fibrostenotic, severe stenosis |
deep fissuring ulcers, sinus tracts |
fistulae to skin or other organs, presence of an inflammatory mass |
fistulizing/perforating |
NA |
mucosal atrophy; regenerative polyps; no mural edema (minimal decrease in luminal diameter) |
reparative or regenerative |
Specialty: Gastroenterology