Case contributed by Naim Qaqish


Abdominal pain and distension.

Patient Data

Age: 60 years
Gender: Male

Dilated small bowel loops (supine view) with multiple large air-fluid levels (erect view) respectively, suggestive of intestinal obstruction.


There are soft tissue mass lesions seen in the distal ileum with ileo-ileal and ileo-colic intussusception (terminal ileum intussuscepting into the cecum).

The lead point is most likely a tumor mass.

There is resultant small bowel intestinal obstruction as the small bowel loops are dilated and filled with fluid demonstrating multiple air-fluid levels.

Pelvic free fluid.

No evidence of retroperitoneal lymph node enlargement.

The liver and spleen are normal in size and have homogeneous texture without evidence of focal lesion.

Pancreas, adrenal glands, and kidneys appear normal.

Case Discussion

This patient presented with a picture of intestinal obstruction clinically and radiologically upon obtaining an abdominal x-ray initially. Further evaluation by CT scan was needed to look for the cause, level of obstruction, and any existent complications. Upon obtaining CT images it turned out to be intussusception of small bowel on itself and with the colon.

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