Image Challenge #1

A 21-year-old man with a history of intermittent central abdominal pain and weight loss with attacks of diarrhea in the last two years. Proper investigation including endoscopy and CT imaging of the abdomen showed narrowing of the terminal ileum lumen causing a partial obstruction. Surgical intervention was decided, during which a loop of the terminal ileum was identified showing mesenteric fat wrapping and thickened bowel wall as shown in the picture.

What is the most likely diagnosis?   

^{Presented by Dr. Ahmed R. Jawad, Consultant Gastroenterology Surgeon, Hepatology and Gastroenterology Center, Najaf, Iraq.} 

Answer: Crohn's disease