He spends some considerable time going through her notes, only to discover that patient last had any barium studies done more than 8 years ago. He initials new studies, Including sinography, with the patronizing support of his consultant.
When the results come through there is no evidence of active Crohn's disease, but sinography confirms several sinuses all confluent on the caecal region.
The patient undergoes laprotomy and resction of the right colon with ileocolic anastomosis. Postoperatively the sinuses heal and all medication is stopped. At review a year later the patient remains well.
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