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. 2026 Apr 8;13:1770748. doi: 10.3389/fmed.2026.1770748

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Copyright © 2026 Li, Hao, Zhou, Ha and Cai.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Panel of twelve medical images arranged in three rows and four columns; the top two rows (A–H) show endoscopic views of the gastrointestinal tract with visible lesions, polyps, strictures, and normal mucosa, marked with blue arrows and yellow asterisks to highlight abnormalities or procedural effects. The bottom row (I–L) presents four microscopic pathology slides at different magnifications, displaying tissue samples with varying cellular architecture and staining patterns, relevant for histological examination of the lesions above. — Dynamic evolution of colonoscopic findings and pathological characteristics in a Crohn's disease patient before and after infliximab (IFX) therapy. (A): Pain-free colonoscopy performed on April 28, 2021 (22 days after the first episode of gastrointestinal bleeding) revealed a 0.6 cm × 0.8 cm ulcer at the inner orifice of the ileocecal valve, with surrounding mucosal congestion and edema (blue arrow). (B): Follow-up pain-free colonoscopy on May 13, 2021 (37 days after the first episode of gastrointestinal bleeding) showed a persistent 0.6 cm × 0.6 cm ulcer at the ileocecal valve (blue arrow). (C): The patient developed massive gastrointestinal bleeding on September 3, 2021; emergency pain-free colonoscopy demonstrated a 1.5 cm longitudinal ulcer on the cecal side of the ileocecal valve with visible microvascular stumps, and no obvious abnormalities were noted in other intestinal segments (blue arrow). (D, E): The patient suffered another episode of massive gastrointestinal bleeding on September 26, 2023; emergency pain-free colonoscopy indicated multiple ulcers in the terminal ileum and ascending colon (blue arrow). (F): Pain-free colonoscopy conducted on January 9, 2024, after 3 courses of IFX therapy showed only residual ulcer at the ileocecal valve, with no abnormalities detected in other intestinal segments (blue arrow). (G, H): Follow-up pain-free colonoscopy on October 24, 2024, after 8 courses of IFX therapy revealed deformation of the ileocecal valve with visible white scars (yellow asterisk), and no ulcers were found in the terminal ileum and entire colon. (I–L): Pathological examination of the lesion tissues collected from the terminal ileum (I, J) and ascending colon (K, L) after the massive gastrointestinal bleeding on September 26, 2023, indicated ulcers with acute active inflammatory changes and inflammatory granulomatous tissue hyperplasia.