PMC5514623_01
Axial (A) and Coronal (B) contrast-enhanced CT scan revealed an extremely dilated jejunal pouch accompanied by pneumatosis cystoides intestinalis (black arrow) and portal venous gas (white arrow)in the left hepatic lobe.
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Abdominal contrast-enhanced CT scan revealed an extremely dilated JP and upper jejunum accompanied by pneumatosis cystoides intestinalis (PCI) in the pouch and PVG in the left hepatic lobe (Fig. 1A and B).
Intraoperative picture showed a fibrous inverted U-shaped jejunal pouch with a whitish surface (black arrow).
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Laparotomy revealed a fibrous inverted U-shaped JP with a whitish surface (Fig. 2).
Elastic fibers (black-blue fibers) in the muscularis mucosae and the subserosa multiplied significantly, accompanied by diffuse fibrosis of the muscularis propria of the pouch. Collagen fibers (greenish fibers: black arrow) also multiplied at the serosal site. (Elastica-Masson stain x 20).
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Collagen fibers had multiplied significantly at the serosal site (Fig. 3), suggesting an intraoperative whitish appearance of the pouch.