PMC6000764_01
The bulky mass on True-FISP characterized by mesenteric pattern (a) with circumferential extension of small bowel loop (b). Diffuse low apparent diffusion coefficients (d,c).
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It displayed hypointense signal on T2w, with low apparent diffusion coefficient (ADC) (mean ADC value 0.6591 x 10-3 mm2/s) (Fig. 1) and homogeneous enhancement (Fig. 2).
various mesenteric lymphadenopathy and mass enveloping of secondary branch mesenteric vessels(a); superior mesenteric artery involvement, though with patent appearance(b).
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PMC6000764_01_gr3.jpg
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A total body computed tomography (CT) was required for initial staging, which confirmed the abnormal mass with a medium size of 9.71 x 8.64.12.62 cm involving also superior mesenteric artery (Fig. 3), thought still patent.
A 10-cm sclerotic and whitish plaque (Fig. 4a) incorporated the first ileal loops and tended to develop towards the mesentery (a); ileal resection extended for approximately 75 cm, including adjacent mesentery and the mesenteric lymph nodes (b); latero-lateral entero-enteric anastomosis (c).
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A 10-cm sclerotic and whitish plaque incorporated the first ileal loops and tended to extend to the mesentery (Fig. 4a). This had led to a retraction of some adjacent loops (Fig. 4b). The intestinal continuity was ensured by a mechanical latero-lateral entero-enteric anastomosis and a perianastomotic drainage was positioned (Fig. 4c).