Bowel inflammatory presentations on computed tomography in adult patients with severe aplastic anemia during flared inflammatory episodes

Figure 6 Characteristic images of case 2. A-C: Characteristic images of the ileocecal region. The ileocecal valve and the terminal ileal wall were thickened and stratified (white arrows), the ileal mucosa was hyperdense and the ileal lumen was liquid-filled. The adhered and clustered distal ileum and cecum with the fibrotically thickened peritoneum (a purple arrow) formed the so-called “abdominal cocoon”; D and E: Characteristic images of the ascending colon and the adhesive bowel loops. In the ascending colon (green arrows), the wall was thickened and stratified with “water holo sign”, the mucosa was hyperdense and the configuration was rugged, with paracolonic fat stranding, omental thickening and subserosal pneumatoses. The wall of the descending and sigmoid colon (red arrows) was also thickened and stratified. In two segments of the adhesive bowel loop (blue arrows and yellow arrows), the bowel wall was heterogeneously thickened and the lumen was gas-filled, suggesting the presence of heterogeneity in small bowel wall texture; F: A particularly striking edematous segment was present in the rectum.