48 year old man with mild diarrhoea off and on for years. Acute episodes would be associated with bloody diarrhoea, fever and right-sided abdominal pain.
The right-sided colon shows patchy thickening of the bowel wall with discrete deep, long serpentine ulcers that penetrate the full-thickness of the bowel wall. Areas of sparing (skip lesions) gives the mucosa a coarsely textured, ‘cobbestone’ appearance with the diseased areas being depressed below the normal mucosa. Some areas of stricture formation (narrowing) may be present.