PMC5856669_01
Intraoperative photograph showing multiple ulcerative lesions in the small bowel mesentery characterising peritoneal dissemination.
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An abdominal computed tomography (CT) scan reported that the appendix was not dilated however there were adjacent fat stranding, suggesting secondary features of inflammation (Fig. 1). Once the purulent fluid was washed out and sent for microscopy and culture, multiple ulcerative lesions throughout the small bowel mesentery and the terminal ileum were noted (Fig. 1).
Initial CT scan of the abdomen on presentation. Green arrow demonstrates appendix with fat stranding.
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Given the thickened stomach, the CT images were rediscussed with the radiological team which suggested that such diffuse gastric wall thickening (Fig. 2, Fig. 3), could resemble the appearance of linitis plastica.