PMC6068080_01
Plain abdominal radiograph (erect) showing fixed dilated small bowel loop in the right hypochondrial region (arrow).
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Plain abdominal radiograph was ordered and showed gas shadow inside the stomach and dilated small bowel loop at the right hypochondrial region (Fig. 1).
Preoperative non-contrast abdominal computed tomography showing fixed dilated small bowel loop (arrow).
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Non-contrast abdominal CT confirmed the presence of the dilated jejunal loop with no definite obstructing cause (Fig. 2).
Operative photo showing herniated small bowel loops through the biliary catheter (arrow) obstructing the bowel mesentry with no signs of strangulation.
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Exploration revealed internal herniation of the small bowel loops around the trans-anastomotic biliary catheter without strangulation (Fig. 3, Fig. 4).