PMC4891552_01
Image from barium small bowel follow-through showing contrast filling a large, irregular extraluminal space (arrows) through a fistula from the lumen of the ileum. Smaller "ulcerations" projected over the opposite side of the lumen (arrowheads) [Powerpoint Slide]
gr1.jpg
PMC4891552_01_gr1.jpg
fig1
A small bowel follow-through exam showed a fistulous connection from the distal ileum into an extraluminal space (6.5 x 3.2 x 2.0 cm) (Figure 1).
A and B. Axial enhanced CT images showing a mass with an enhancing, thick wall (arrows), with internal air, fluid, and a linear ossific density (arrowhead) suggesting bone. [Powerpoint Slide]
gr2.jpg
PMC4891552_01_gr2.jpg
fig2
A CT of the abdomen and pelvis showed a thick-walled mass in the pelvis containing air, fluid, and a linear ossification, thought to be ingested bone (Figure 2).
A. Axial CT with lung window settings of the upper abdomen showing free intraperitoneal air (arrows). B. Axial contrast-enhanced CT image after percutaneous drainage with drainage catheter within the mass. [Powerpoint Slide]
gr3.jpg
PMC4891552_01_gr3.jpg
fig3
A CT examination two days after the drainage showed no significant change in the air/fluid collection, a small amount of new ascites, and new free intraperitoneal air (Figure 3).