Double contrast barium enema demonstrates ileocecal valve region. The cecum is fibrotic and contracted (arrow), the ileocecal valve is irregular, narrowed, gaping, and incompetent (small arrowhead), and the terminal ileum appears to empty directly into the ascending colon (Stierlin's sign; region of small arrowhead). Note the diffuse ulcerations in the ascending colon (large arrowheads) and the lymphoid follicles in the terminal ileum (triple arrow).