A liver with a highly abnormal appearance.

A 33-year-old man with Crohn's disease presented with 3 days of abdominal pain, bloody diarrhoea and vomiting. He was clinically stable and blood tests showed an isolated C reactive protein of 81. Ultrasound (US) scan showed a small air and fluid collection in the right iliac fossa and a highly abnormal liver architecture. An abdominal CT scan was performed (figures 1 and 2). Figure 1 CT scan showing a distal ileal mass, local perforation and air within …