Comb sign in Crohn's disease

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Crohn's disease (CD) is a chronic inflammatory bowel disease.
• Accurate diagnosis and monitoring of CD exacerbations are crucial for patient management.

Observation:

• A 13-year-old boy presented with symptoms of CD exacerbation, including abdominal pain and diarrhea.
• CT imaging revealed active ileum and rectosigmoid colon inflammation with the characteristic "comb sign."

Findings:

• The "comb sign" describes mesenteric hypervascularity with dilated, tortuous vasa recta resembling a comb.
• This sign can help identify acute CD exacerbations and distinguish active CD from hypovascular diseases like lymphoma.
• The comb sign's severity correlates with endoscopic findings in CD.

Implications:

• The comb sign is a valuable imaging biomarker for active Crohn's disease.
• It can assist clinicians in diagnosing and managing CD flares.
• Further research may explore its role in predicting disease progression or treatment response.