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Transmesenteric internal hernia, small bowel volvulus

Harshany MLH - MedPix

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Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: Transmesenteric internal hernia, small bowel volvulus

History: 27 y/o woman with sudden onset of periumbilical abdominal pain relieved only by "bending forward". Previous surgery - gastric bypass 2 years ago.

Findings: Early studies demonstrate an internal transmesenteric small bowel hernia without volvulus or ischemia. Recent study demonstrate the "whirl" sign - indicating twisting of the bowel and, hence, volvulus. No evidence of intestinal ischemia or necrosis on CT (no submucosal enhancement, bowel wall thickening, free fluid or pneumatosis intestinalis).

Ddx: Clinical difeerential diagnosis: <li> Acute appendicitis <li> Acute cholecystitis <li> Mesenteric ischemia <li> Volvulus Imaging findings are diagnostic.

Dxhow: Surgery

Exam: Severe periumbilical pain, peritoneal signs. Unable to tolerate oral contrast.

No MeSH data available.


Note that there are no secondary findings for intestinal ischemia (no bowel dilatation, submucosal enhancement, wall thickening or free fluid) suggesting a still viable small bowel (confirmed intraoperatively)
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MPX2481_synpic23903: Note that there are no secondary findings for intestinal ischemia (no bowel dilatation, submucosal enhancement, wall thickening or free fluid) suggesting a still viable small bowel (confirmed intraoperatively)


Transmesenteric internal hernia, small bowel volvulus

Harshany MLH - MedPix

Note that there are no secondary findings for intestinal ischemia (no bowel dilatation, submucosal enhancement, wall thickening or free fluid) suggesting a still viable small bowel (confirmed intraoperatively)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2481&req=5

MPX2481_synpic23903: Note that there are no secondary findings for intestinal ischemia (no bowel dilatation, submucosal enhancement, wall thickening or free fluid) suggesting a still viable small bowel (confirmed intraoperatively)

View Article: MedPix Image - MedPix Case

Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: Transmesenteric internal hernia, small bowel volvulus

History: 27 y/o woman with sudden onset of periumbilical abdominal pain relieved only by "bending forward". Previous surgery - gastric bypass 2 years ago.

Findings: Early studies demonstrate an internal transmesenteric small bowel hernia without volvulus or ischemia. Recent study demonstrate the "whirl" sign - indicating twisting of the bowel and, hence, volvulus. No evidence of intestinal ischemia or necrosis on CT (no submucosal enhancement, bowel wall thickening, free fluid or pneumatosis intestinalis).

Ddx: Clinical difeerential diagnosis: <li> Acute appendicitis <li> Acute cholecystitis <li> Mesenteric ischemia <li> Volvulus Imaging findings are diagnostic.

Dxhow: Surgery

Exam: Severe periumbilical pain, peritoneal signs. Unable to tolerate oral contrast.

No MeSH data available.