PMC6029008_01
A 59-year-old Caucasian female presents with epigastric pain, jaundice, vomiting and constipation. (a) Erect chest radiograph reveals dilated hollow viscus (yellow arrow) beside the stomach (red arrow). (b) Abdominal radiograph shows multiple prominent loops of small bowel. (c) Coronal view of computed tomography abdomen and pelvis shows the dilated cecal pole within the lesser sac, corresponding with the radiographic findings.
JCIS-8-24-g002.jpg
PMC6029008_01_JCIS-8-24-g002.jpg
F1
A plain radiograph of her chest and abdomen [Figure 1a and b] revealed a dilated loop of bowel within the left upper quadrant. This prompted an urgent CT abdomen and pelvis which uncovered a dilated cecum [Figures 1c and 2] within the lesser sac through the foramen of Winslow.
Multiple planes of computed tomography depicting the twisted, herniated cecum within the lesser sac. Reconstructed images: (a) axial, (b) oblique coronal, (c) coronal, and (d) sagittal views.
JCIS-8-24-g003.jpg
PMC6029008_01_JCIS-8-24-g003.jpg
F2
This prompted an urgent CT abdomen and pelvis which uncovered a dilated cecum [Figures 1c and 2] within the lesser sac through the foramen of Winslow.
Computed tomography abdomen showing (a) axial view and (b) coronal view of intrahepatic ductal dilatation resulting from pressure on the biliary tree. Also note surrounding ductal edema and fluid in the gallbladder fossa. (c) Axial view showing sharp angulation of the cystic duct (red arrow).
JCIS-8-24-g004.jpg
PMC6029008_01_JCIS-8-24-g004.jpg
F3
This resulted in a combination of intrahepatic ductal dilatation and edema [Figure 3a and b]. In addition, there was sharp angulation of the cystic duct [Figure 3c].