Intestinal Perforation Due to Crohn's Ileitis Immunosuppression Related Lymphoma and Meckel's Diverticulum

Abstract

A 74-year-old woman with an 8-year history of Crohn’s disease on long-standing adalimumab and azathioprine presented with severe, acute abdominal pain. One-month prior, computed tomography enterography obtained for poor appetite and weight loss was suggestive of ileitis with 2 segments of prominent bowel thickening (Figure A). Colonoscopy showed ulcerated terminal ileum and 2 partially obstructing masses (Figure B) with an atypical large B-cell infiltrate on histology.