PMC9054471_01
Erect (a) and supine (b) abdominal X-ray radiographs showing colonic fecal and gas content.
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fig1
NCCT abdomen showing left lumbar regional mesenteric swirling sign (red box), and mildly dilated abnormally located proximal jejunal loops at the left upper quadrant (yellow arrow).
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fig2
CT abdomen and pelvis with IV, oral, and rectal contrasts showing the jejunal loops project lateral to the sigmoid in the left lumbar region (green arrows).
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fig3
A CT abdomen and pelvis with IV, oral, and rectal contrasts was done, and showed regression of the previously seen left lumbar regional mesenteric swirling sign, with regression of the left upper quadrant located proximal jejunal loops distension, more caudally, the jejunal loops project lateral to the sigmoid in the left lumbar region suggesting medially located distal descending colon due to a dolichocolon extends up to left upper quadrant with no evidence bowel obstruction (Figure 3).
Diagnostic laparoscopy showing collapsed distal jejunal loops (blue arrow) and dilated proximal loops (black arrow).
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fig4
The patient was taken to the operating room the following day where he underwent diagnostic laparoscopy which revealed collapsed distal jejunal loops and dilated proximal loops (Figure 4), a V-shaped intersigmoid fossa containing jejunal loops (Figure 5), and lateral abdominal wall adhesions creating a defect.
Diagnostic laparoscopy showing intersigmoid fossa (black arrow) containing jejunal loops.
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fig5
The patient was taken to the operating room the following day where he underwent diagnostic laparoscopy which revealed collapsed distal jejunal loops and dilated proximal loops (Figure 4), a V-shaped intersigmoid fossa containing jejunal loops (Figure 5), and lateral abdominal wall adhesions creating a defect.