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Crohn disease — ABFM Board MCQ

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HardGI/HepatologyCrohn diseaseABFM Board

A 28-year-old man has 3 months of crampy abdominal pain, nonbloody diarrhea, and weight loss. He has perianal pain and a draining fistula. CRP is elevated and colonoscopy shows patchy ileocolonic ulceration. Which of the following is the most likely diagnosis?

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Correct answer: A — Crohn disease

Patchy ileocolonic inflammation with perianal fistula and systemic inflammatory markers strongly suggests Crohn disease. Ulcerative colitis usually causes continuous colonic disease beginning in the rectum.

Reference: ACG Crohn Disease Guideline