Presentation
Patient presented with symptoms of small bowel obstruction
Patient Data
Dilated small bowel loops up to 3.4 cm. A cluster of small bowel loops is seen lateral and inferior to the 2nd part of duodenum (D2), herniating through the Waldeyer's fossa with no visibility of the 3rd part of the duodenum (D3) in its normal position. The superior mesenteric artery (SMA), and superior mesenteric vein (SMV) are seen along the anteromedial aspect of the hernia orifice, well-visualized on axial as well as the reconstructed images. Note volvulus of the bowel loops within the hernial sac well-visualized on the sagittal and coronal reconstruction. Mild peritoneal effusion is noted in the pelvic region.
Two hepatic hemangiomas are noted as well as small simple renal cysts.
Case Discussion
CT features are of a right anterior paraduodenal internal hernia with small bowel obstruction which was confirmed at surgery.
Additional contributors/ R. Bouguelaa, MD and C. Boukaaba, MD
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