Understanding the Presentation of Terminal Ileitis

Abstract

Our patient is a 47-year-old African American female with a past medical history of recurrent episodes of small bowel obstruction. She presented to the emergency department with symptoms of nausea, vomiting, and abdominal pain. Upon further evaluation, imaging showed obstruction at the terminal ileum. Based on the holistic clinical presentation, we initially thought that this patient was experiencing symptoms of early onset Crohn’s disease. Gastroenterology evaluated the patient and was uncertain of the formal diagnosis. Colonoscopy and biopsy were not pathognomonic for Crohn’s disease, suggesting that there may be a component of terminal ileitis or another inflammatory bowel disease process. This case exemplifies the degree to which these inflammatory bowel disease processes frequently overlap.

Samidhā: A Review

“…palāśasamidhaḥ śastāścaturthe'hni tathotsavaḥ. This passage underscores that offerings should be made with clarified butter and grains, and the use of palash samidhā during the yagya ritual is auspicious [48].…”

“…This verse suggests that for the grahsthapa ritual, the Dvij (one who wears the sacred thread) should use samidhā from both sesame and Palāśa (sacred tree) [48].…”