PMC9997574_01
(a) X ray erect abdomen showing multiple air fluid levels (b) Multiple large perforations involving proximal ileum (bold arrow) (c) Areas of impending perforations in distal ileum (linear arrow) (d) Section shows ribbons of broad, aseptate fungal hyphae with obtuse angled branching.(bold triangle)
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F1
Erect X-ray abdomen and pelvis showed multiple air-fluid levels [Figure 1a]. On exploratory laparotomy, multiple large ileal perforations (more than 10 perforations) were noted intraoperatively with many impending perforations in the distal ileum [Figure 1c]. Around 15 cm of proximal ileum containing 3-4 large perforations, which were almost appearing like near-complete bowel transactions [Figure 1b] was resected with the closing of around 8-9 distal perforations and inverting the areas with impending perforations. Angioinvasion was also noted [Figure 1d].