Transmural thickening and enhancement of the distal ileum. Hyperaemia in the supplying mesentery and minor stranding in the surrounding fat. Marked dilatation of proximal small bowel, calibre up to 4.2 cm, with multiple air-fluid levels. Small bowel faeces sign distally and dilated segment. Transition point at the right iliac fossa, at the abnormally thickened segment of distal ileum. Small amount of free fluid in the peritoneal cavity, but no free gas. Multiple prominent lymph nodes in the small bowel mesentery. The large bowel has unremarkable imaging appearances. The liver, gallbladder, pancreas, adrenal glands, spleen, and kidneys have normal appearances. The lungs and pleural bases are clear. No suspicious bone lesions.
Conclusion: Distal ileitis consistent with Crohn's disease. Mechanical small bowel obstruction with transition point in the distal ileum at the right iliac fossa. Morphological abnormality of small bowel loop in this location favour inflammatory stricture over adhesion as the cause of obstruction.