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A and 1B: CT scan shows dilated small bowel loops with transition zone located left to the Treitz ligament (green arrow) and saclike appearance (green circle).
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Abdominal computed tomography scanner (CT scan) confirmed the diagnosis of SBO with transition zone left to the Treitz ligament (Fig. 1A and B) and showed a sac-like appearance in left paraduodenal fossa located posterior to the mesentery of the left colon and the left portion of the mesentery of the transverse colon measuring 30 cm (Fig. 1A) suggesting of a left paraduodenal hernia.
Intra-operative photograph showing the hernia sac in landzert fossa posterior to the descending mesocolon that contains dilated small bowel loops.
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At exploration, a huge hernia sac (Fig. 2) arising from a peritoneal opening (Fig. 3) located left to the