Concurrent Terminal Ileocaecal Crohn’s Disease and Terminal Ileal Endometriosis: Multimodal Assessment with CT, MRI, and PET/CT Imaging

Introduction

Crohnʼs disease (CD), a kind of chronic inflammatory bowel illness, commonly affects the terminal ileum and coecal area. Clinical signs are frequently mild and rely on the disease's inflammatory activity. In women of childbearing age, florid intestinal endometriosis can mimic CD. Furthermore, modern pathophysiological ideas identify intestinal endometriosis as a potential founder lesion for successive CD creation. When the terminal ileum is afflicted in a woman of childbearing age, endometriosis should be considered [1].

Endometriosis, on the other hand, is defined by the development of endometrial tissue in locations other than the uterus, such as the ovaries, peritoneum, and intestinal system. Despite the advancement of contemporary technology, the basic process of endometriosis remains a mystery. Its relapse occurs primarily in the third decade of human life [2]. The most noteworthy aspect is that endometriosis typically affects the digestive tract in 4 to 40 percent of individuals. The recto-sigmoid, proximal/middle colon, appendix, and ileum are the most typically afflicted areas. Intestinal endometriosis, like CD, has non-specific symptoms such as stomach discomfort, (bloody) diarrhea, constipation, and segmental inflammation [3].

Publication History

Received: 11 June 2025

Accepted after revision: 19 July 2025

Article published online:
30 July 2025

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