Presentation
History of abdominal distension. Blood PR. Recent hill-walking trip. Has drunk water from a stream. ? infection ? inflammation.
Patient Data
Gross bowel wall thickening. Free fluid.
Normal appendix and solid abdominal organs.
Profoundly abnormal bowel on all sequences (limited sequences uploaded). There is diffusion restriction through all bowel loops which are grossly thickened with interposing loop fluid.
Large bowel is less abnormal.
Multifocal peripheral renal diffusion restriction.
Bilateral pleural effusions.
Case Discussion
The dominant abnormality is located within the small bowel. At ultrasound, the differential here is between infection, inflammation and neoplasia. The latter was confirmed at colonoscopic biopsy as Burkitt lymphoma.
Chemotherapy treatment started. The child responded well and achieved remission. There has been no recurrence.
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