Small Bowel Inflammation
This case is a diagnostic mystery. This 51 yr old previously well man presented 5 days post eating 2 day old pasta with bowels not opened for 5 days, AXR: small bowel air fluid levels, and a few hours later watery diarrhoea. He worked on a Horse farm. Stool cultures negative. His symptoms did not settle. His CRP was 270, with normal WCC. IV Antibiotics were commenced. A CT scan showed proximal small bowel air fluid levels at level of the DJ flexure. A Laparoscopy was completed which showed dilated small bowel to level of the DJ flexure. A Enteroscopy was completed which showed significant inflammatory changes (see high res video). Histology showed neutrophilic cell infiltrate ? infective cause. Options for diagnosis ?
