Sections examined revealed extensive ulceration of ileal mucosa with panmural infiltration by neutrophils, lymphocytes, plasma cells and histiocytes. Inflammation involves the serosal covering with related capillary proliferation and fat necrosis. The resection margins are unremarkable. No evidence of specific granulomas. No evidence of malignancy. Omental tissue showing degenerated fat cells with related focal dense inflammatory cell infiltrate formed of foamy histiocytes, plasma cells, lymphocytes and some neutrophils. There is associated moderate fibrosis. Dissected 7 lymph nodes show reactive follicular lymphoid hyperplasia. No evidence of specific granulomas. No evidence of atypia or malignancy.
Intestinal obstruction. Laparotomy revealed patchy gangrenous areas and perforated areas.
Resected part of ileum 43 cm, long. Showing three hemorrhagic areas 0.7 cm - 1.7x0.6 cm with related perforation located 13 and 14 cm from both resection margins. Adherent omental fat 13x3.5 cm, grossly unremarkable. Dissected regional lymph nodes 0.3-0.7 cm, all are soft.
Ileum, segmental resection: