OBJECTIVE.Idiopathic localized dilatation of the ileum is a rare entity characterized by a sharply demarcated segmental dilatation of the small bowel that is in line with the and In one, the lesion was seen on a barium enema with reflux into the ileum. The mean age of patients was 52 years. In seven cases, pathologic correlation was available.In the other two patients, long-term clinical follow-up and repeat studies confirmed the diagnosis. Resected specimens showed a thin but otherwise normal wall with normal ganglion cells and nerve plexuses. Ulceration was noted in six of the seven resected cases. Two cases contained heterotopic gastric mucosa. Gi bleeding and/or anemia was the most common (77%) presenting symptom. Abdominal pain and/or obstruction was present in slightly less than half the patients (44%).RESULTS. Lesions were 6-21 cm long and 4-13 cm wide, and all were located in the ileum. The dilated segments were bilobate in three cases, multilobate in three, spherical in two, and tubular in the other. The dilated area was always in line with the long axis of the bowel, not projecting to the side. No surrounding masses were seen. Except in three patients in whom ulcers were noted, the mucosa was normal.CONCLUSION. Idiopathic localized dilatation of the ileum should be suspected whenever a sharply demarcated area of lobulated small bowel dilatation is seen in a middle-aged patient with occult Gi bleeding. The axial orientation distinguishes this condition from small bowel diverticula (including Meckel's). The lack of surrounding mass, mucosal irregularity, hypermotility, or fistulae help differentiate it from other causes of small bowel dilatation.

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Enterolithiasis is a rarely encountered clinical and radiologic entity. Stasis of intestinal contents is the underlying cause of the stone formation. Four cases are presented, 3 in the colon and 1 in the small bowel. The chemical composition of these stones varies according to their site of origin. The clinical setting varies widely as does the radiologic differential diagnosis.

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CPA varices, particularly on the right side, are not uncommon in patients with PHT. Varices should be considered and excluded as a cause of CPA masses, particularly before percutaneous biopsy. Delayed CT may be necessary to correctly delineate CPA varices.

Acute thermal injury to the esophagus has not been reported previously in the radiographic literature. We present a case of a young adult who developed an intramural "blister" that ultimately communicated with the esophageal lumen. A double-contrast esophagogram outlined the resulting mucosal flap. A brief review of other injuries to the esophagus is included.

The cholecystohepatic duct of Luschka is demonstrated. This anomaly directly connects the gallbladder to the bile ducts, draining a portion of the right lobe of the liver. The pertinent embryology is reviewed. When accidentally severed, it may cause a bile leak leading to biloma formation. It should be recognized before surgery to alert the surgeon.

Enteral alimentation is a crucial component of care for the malnourished patient who cannot eat. Until recently, long-term alimentation was delivered through nasogastric tubes or gastrostomy tubes placed at surgery. In the past few years, percutaneous endoscopic gastrostomy (PEG) has almost completely supplanted these traditional methods. PEG is a safer and better-tolerated procedure. The advantages of PEG over nasogastric tubes include greater social acceptance and improved cosmetic appearance, increased ease of feedings, and decreased nasal alar deformities and gastroesophageal reflux. Complications are less common with PEG than with open gastrostomy but still occur in as many as 15% of cases [1-3]. Percutaneous gastrostomies performed using fluoroscopic guidance have complications in approximately 10% of cases [4]. Despite a rapid increase in the use of percutaneous gastrostomies and their placement by radiologists [4], few published reports have described imaging findings after the placement of such tubes. This pictorial essay illustrates a spectrum of normal and abnormal imaging findings observed with the use of PEG tubes, including tube migration and misplacement, infection, tumor seeding along the PEG tube track, and a variety of gastric wall defects and pseudomasses.