Distal ileal perforation (June week2)

Small amount of free fluid in abdomen and pelvis with extraluminal air, more marked in bilateral anterior subphrenic spaces and paraumbilical non-dependent spaces. (marked pneumoperitoneum) – *represents hollow viscus perforation*

Marked long segment circumferential mural thickening small bowel loops, ascending, transverse, descending colon and rectosigmoid colon with marked surrounding mesenteric fat stranding and thickening – *suggestive of enterocolitis, likely related to inflammatory bowel disease*

*A thickened distal ileal loop in right lower quadrant demonstrates small defect at the lateral wall with surrounding mesenteric thin walled collection – represents site of bowel perforation*