During an operation for presumed appendicitis the appendix was found to be normal; however, the terminal ileum is evidently thickened and feels rubbery, its serosa is covered with grayish-white exudate, and several loops of apparently normal small intestine are adherent to it. The most likely diagnosis is:

Answer options

1. Perforated Meckel’s diverticulum
2. Acute ileitis
3. Ulcerative colitis
4. Crohn’s disease of the terminal ileum
5. Ileocecal tuberculosis

Explanation

During an operation for presumed appendicitis the appendix was found to be normal; however, the terminal ileum is evidently thickened and feels rubbery, its serosa is covered with grayish-white exudate, and several loops of apparently normal small intestine are adherent to it. The most likely diagnosis is:Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus. Mostly affected in Crohn's disease is terminal ileum. Skip lesions, transmural involvement are the main characteristics of this disease.