DAVID SUTTON PICTURES THE SMALL BOWEL AND PERITONEAL CAVITY ONLY FOR STUDY PURPOSE

1. 20
DAVID SUTTON

2. DAVID SUTTON PICTURES
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig. 20.1 Compression paddle. The patient lies
prone on the paddle and the balloon is
inflated to compress overlying small-bowel
loops during fluoroscopy.

4. • Fig. 20.2 : Small Bowel Enema.

5. • Fig. 20.3 Normal ileostomy enema.

6. • Fig. 20.4 Non-ionic, water-soluble follow-
through performed using iohexol in a
postoperative patient.

7. • Fig. 20.5 Plain
abdominal film
reveals a dilated
jejunal loop in this
patient with
obstruction secondary
to an internal hernia
(note residual
contrast in the
appendix from recent
barium enema).

8. • Fig. 20.6 CT shows unequivocal small bowel
obstruction.

9. • Fig. 20.7 Multislice CT with reconstruction shows no
mass at the transition point between dilated (curve
arrow) and undilated (straight arrow) small bowel.
Diagnosis: adhesions, confirmed at subsequent
laparotomy.

10. • Fig. 20.8 Barium follow-through in a patient with
adhesions. There is an abrupt transition point from
dilated to undilated small bowel in this patient with
obstruction to the afferent limb of an ileoanal pouch.

11. • Fig. 20.9 Scleroderma.

12. • Fig. 20.10 Primary visceral myopathy. Note
the characteristic, massively dilated duodenal
loop (arrow).

13. • Fig. 20.11 Crohn's disease. Compression view
reveals an intense mucosal granularity,
caused by villous oedema.

14. • Fig. 20.12 Crohn's disease. Fold thickening.

15. • Fig. 20.13 Crohn's disease. Compression of an
ileal loop reveals several aphthous ulcers (one
of which is arrowed). Also note the
background granularity caused by villous
oedema.

16. • Fig. 20.14 Advanced Crohn's disease
evidenced by several, long 'cobblestone‘
segments with intervening dilatation.

17. • Fig. 20.15 Advanced Crohn's disease with
several characteristic pseudodiverticula
(arrows).

18. • Fig. 20.16 Crohn's disease. Neoterminal ileal
recurrence at right hemicolectomy site.

19. • Fig. 20.17 Crohn's disease. CT reveals a
parastomal hernia when the patient is in the
right lateral position.

20. • Fig. 20.18 Crohn's disease. Normal Kock
pouch.

21. • Fig. 20.19 Crohn's disease. Ultrasound reveals
gross mural thickening in an ileal loop.

22. • Fig. 20.20 Crohn's disease. CT shows the
extent of terminal ileal thickening (arrows).

23. • Fig. 20.21 Crohn's disease. Fat suppressed T2-
weighed MR scan shows thickened ileal loops
(curved arrows) and also reveals a parastomal
abscess (straight arrow).

24. • Fig. 20.22 Benign stromal tumour. (A) Barium
follow-through reveals an intraluminal mass
(arrow) on compression. (B) The tumour is
also visible on CT (arrow).

25. • Fig. 20.23 Small bowel adenocarcinoma
(between arrows) complicating Muir-Torre
syndrome.

26. • Fig. 20.24 Lymphoma. Diffuse fold thickening
and nodularity.

27. • Fig. 20.25 Lymphoma. CT reveals a well-
demarcated soft-tissue mass.

28. • Fig. 20.26 CT reveals a desmoplastic reaction
in a patient with carcinoid tumour.

29. • Fig. 20.27 CT reveals a large pelvic soft-tissue
mass that proved to be recurrent stromal
tumour.

30. Fig. 20.28 Duodenal adenomas (some of which
are arrowed) complicating familial
adenomatous polyposis.

31. • Fig. 20.29 Familial adenomatous polyposis.
T2 -weighted MR image of a mesenteric
desmoid tumour (arrows).

32. • Fig. 20.30 Barium follow-through reveals an
ileal hamartoma (arrow) in Peutz-Jeghers
syndrome.

33. • Fig. 20.31 Barium follow-through in a patient
with extensive radiation enteritis reveals
strictures, dilatation and a 'picket-fence'
appearance (arrows).

34. • Fig. 20.32 Gross intramural jejunal
haemorrhage revealed by CT in a young man
taking oral anticoagulants.

35. • Fig. 20.33 Small-bowel thickening, causing a
'target' sign, in a young woman with Henoch-
Schönlein purpura (arrows).

36. • Fig. 20.34 Barium follow-through reveals a
large Meckel's diverticulum (arrows).

37. • Fig. 20.35 Terminal ileum nodular lymphoid
hyperplasia.

38. • Fig. 20.36 Plain film showing pneumatosis
intestinalis evidenced by (arrows). innumerable
air-filled cysts.

39. • Fig. 20.37 Peritoneal attachments and potential spaces
when viewed from the front (A) and side (B); (A) also
demonstrates likely pathways for pathological spread.

40. • Fig. 20.37 Peritoneal attachments and
potential spaces when viewed from the front
(A) and side (B); (A) also demonstrates likely
pathways for pathological spread.

41. • Fig. 20.38 CT reveals deposits on the liver
surface (arrow) in this patient with ovarian
carcinoma (note splenic ascites).

42. • Fig. 20.39 Contrast-enhanced CT reveals
plaques of high-attenuation peritoneal
deposits in a patient with disseminated
colorectal adenocarcinoma.

43. • Fig. 20.40 CT reveals the liver scalloping
typical of pseudomyxoma.

44. • Fig. 20.41 Barium follow-through shows
distal ileal encasement in mesenteric
panniculitis.