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Crohn's Disease — RACP Adult Medicine MCQ

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EasyGastroenterologyCrohn's DiseaseRACP Adult Medicine

A 25-year-old man presents with 3 months of right iliac fossa pain, weight loss, and non-bloody diarrhoea. He has perianal fistulae on examination. Colonoscopy shows skip lesions with deep serpiginous ulcers in the terminal ileum and caecum. Biopsies reveal non-caseating granulomata. What is the most likely diagnosis?

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Correct answer: C — Crohn's disease

Skip lesions, deep ulcers in the terminal ileum, perianal disease, and non-caseating granulomata are hallmarks of Crohn's disease. The transmural inflammation pattern distinguishes it from UC. Initial therapy depends on severity and may include exclusive enteral nutrition, corticosteroids, or anti-TNF agents.

Reference: Gastroenterological Society of Australia – 2024 – IBD Guidelines