Imaging infection and inflammation of the terminal ileocecal region: Emphasis on typhoid

The latter occurs due to necrosis of the Peyer's patches in the terminal ileum, resulting in ulceration, bleeding and, in extreme cases, full thickness perforation (Figure 5).11 Causes of perforation include inadequate antimicrobial treatment prior to admission, short duration of symptoms and leucopenia.1 Active bleeding is seen as contrast extravasation on CT angiography. Multiple air-fluid levels can be present in the colon due to increased fluid and liquid feces.4, 12 Enlarged mesenteric lymph nodes are seen adjacent to the involved segment .4, 7 Thickening of the terminal ileum and proximal colon is typical (Figure 6).7 Salmonella enteritis may simulate other causes of intestinal wall thickening such as tuberculosis, Crohn's, neutropenic typhilitis, ischemic bowel, other infectious enteritis and malignancies of the ileocecal region.