Clinical presentation

A 22-year-old woman was referred with a 4-week history of bloody diarrhoea, tenesmus, abdominal and rectal pain. Prior to presentation, a prednisone taper had been initiated given suspicion for Crohn’s disease. Her medical history was otherwise unremarkable. Physical exam showed normal vital signs and mild left lower abdominal tenderness without peritoneal signs. Laboratory evaluation was significant for mild leucocytosis (white blood cell count 14.3×10⁹/L (normal range 3.5–10.5×10⁹/L)). CT scan of the abdomen/pelvis showed hazy mesenteric fat stranding, mural thickening, oedema and hyperenhancement involving the rectosigmoid colon with widely …