A segment of small bowel has a markedly, circumferentially thickened wall (image 1). The peripheral margins of the intestinal mass are multilobulated, with subtle finger-like projections surrounded by mildly echogenic omentum and mesentery, suggesting serosal layer interruption (short arrows.) The ovoid, echogenic focus visualized within the mass at the 1 o`clock position represents the beveled surface of a 22-gauge needle (long arrow.) Continuous hypoechoic mass is visible within the bowel wall indicated by the hyperechoic luminal interface indicating that this mass derives from the intestine. Mural detail is completely lost (Video 1.)