PMC3551681_01
Axial enhanced CT demonstrates a cluster of dilated jejunal loops located in the Landzert s fossa.
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F1
An urgent abdominal CT scan confirmed the diagnosis of small bowel obstruction secondary to what looked like a hernia into the left paraduodenal fossa (fossa of Landzert) (Figure  1).
A)Operative finding of hernia sac in the fossa of Landzert containing small bowel loops.B) Abnormal congenital band (ligament of Treitz) containing inferior mesenteric vein. C) A potential space in the large bowel mesentery (arrow) with hernia sac was laid opened.
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F2
At laparotomy, a hernia sac of 25 cm in diameter arising from a defect just to the left of the fourth part of the duodenum was found, consistent with a LPDH (Figure  2A). A band containing the inferior mesenteric vein was deemed necessary to divide at the time in order to widen the orifice of the defect and to retrieve the dilated small bowel from the hernia sac (Figure  2B). The hernia sac was excised completely down to the base at the mesentery of large bowel (Figure  2C).