An 11-year-old boy is brought to the ED with a 1-week of history of increasing crampy lower-quadrant abdominal pain. His vital signs were only significant for mild tachycardia. On physical examination, the child’s abdomen was tender to palpation in the bilateral lower abdominal quadrants with guarding. Laboratory evaluations were unremarkable.
An abdominal radiograph did not reveal any abnormality, and targeted ultrasound did not reveal a dilated appendix. Computed tomography (CT) of the abdomen and pelvis with oral and intravenous contrast were ordered and representative images are provided (Figures 1a and 1b). Note that additional images from the CT demonstrate the abnormality depicted in these figures was not a loop of small bowel (although it appeared to originate from a loop of distal small bowel) and that the appendix was normal.
What is the diagnosis?