PMC7339025_01
Abdominal CT scan.. (A) Axial CT image demonstrated an intra-abdominal free fluid.. (B) Axial CT image demonstrated a pneumoperitoneum and significant fat stranding in the small bowel mesentery.. (C) Axial CT image demonstrated a pneumoperitoneum and significant fat stranding surrounding a jujenal segment of small bowel, which shoes gas locules at its wall representing the site of perforation.. (D) Axial CT image demonstrated a focal hypo-attenuating wall thickening of small bowel segment and air fluid level.
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An abdominal CT scan with IV contrast enhancement was performed after initial resuscitating, it showed pneumoperitoneum with significant fat stranding in the small bowel mesentery (see Fig. 1).
Intra operative photos demonstrating.. (A) Hard mass arising from mid jejunum with extensive adhesion to other small bowel loops.. (B) Mass of 10 cm arising from mid jejunum.. (C) Extensive adhesion to other small bowel loops.. (D) Site of perforation at the mesenteric side.
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Apart from the proximal 40 cm of the jejunum and the distal 30 cm of the ileum, the whole length of the small bowel was diseased and could not be preserved (See Fig. 2).