1. Presented by Peter Illei, M.D. and prepared by Danielle Wehle, M.D.

The patient is a 59 year old woman with a 30 year history of Crohn"s disease complicated by a recent flare and a right lower quadrant mass. Clinically, a distal ileal obstruction secondary to an interloop adhesion was suspected. During surgery the terminal ileum appeared strictured and contained a mass that was adherent to the urinary bladder as well as the sigmoid colon. The mass was carefully dissected of the urinary bladder and a right hemicolectomy and a partial sigmoidectomy was performed. Grossly, the specimen showed a 15 cm narrow strictured area in the terminal ileum with puckered and inflamed serosa and serosal adhesion.

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