20

DAVID SUTTON

DAVID SUTTON PICTURES

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• 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.

• Fig. 20.2 : Small Bowel Enema.

• Fig. 20.3 Normal ileostomy enema.

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

• 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).

• Fig. 20.6 CT shows unequivocal small bowel obstruction.

• 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.

• 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.

• Fig. 20.9 Scleroderma.

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

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

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

• 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.

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

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

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

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

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

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

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

• 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).

• 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).

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

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

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

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

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

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

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

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

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

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

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

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

• Fig. 20.35 Terminal ileum nodular lymphoid hyperplasia.

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

• 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.

• 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.

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

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

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

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