PMC5143428_01
Abdominal CT findings.. A thickening of the wall was found in the small bowel, and the enhancement with contrast medium was weakened ( : short tail arrow). Gas in the intestinal wall was found in the small bowel ( : long tail arrow).
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Contrast-enhanced multi-detector computed tomography (CT) on day 3 demonstrated thickening of the small bowel wall, poor staining of the wall, and intramural emphysema (Fig. 1).
Selective SMA angiography findings.. (A) The proximal SMA was intact, but distal branches were spastic on day 3. (B) The spasm of the distal branches improved on day 6.
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In addition, angiography revealed diffuse spasms in the branches of the proximal SMA (Fig. 2A). Angiography on day 6 demonstrated an improvement of the circulation of SMA (Fig. 2B).
Macroscopic findings.. Due to the thickening of the wall, a severe stricture of the ileum was found in two sites which were adhering to each other causing bowel obstruction.
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According to pathological examination, two sites of stricture were found in the ileum, which were adhering to each other causing obstruction (Fig. 3).
Microscopic findings.. (A) Fibrosis was found in the sub-mucosal layer. (B) Ulcer formation was observed in the stricture site of the ileum.
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Moreover, in the stricture sites of the ileum, severe thickening was found with fibrosis in the sub-mucosal layer (Fig. 4A). An ulcer formation was also observed in the stricture site leading to perforation (Fig. 4B).