Chronic diarrhoea, Fever ...

An older man with chronic diarrhoea, Fever and bloody purulent stool abdominal pain was admitted to the hospital. He had a H/o upper GI bleeding from a duodenal ulcer 20 years ago with signs of regurgitation, heartburn, nausea, anorexia, fatigue, and weight loss. All vitals and laboratory results were normal. The antineutrophil cytoplasmic and antinuclear antibodies were found positive. Active duodenal ulcer was found using gastroscopy. Multiple ulcers in the segmented design were noted in the left hemi-colon using colonoscopy.

Meanwhile, the patient experienced noticeable chest pain and dyspnoea, worsening upon a deep breath. In addition, two-sided basal thickening was found in CT images, as shown in the figure.