PMC5516733_01
Axial CT image shows distended proximal bowel loop and collapsed distal loop (white arrow) at a transition zone (black arrow) between the uterus (asterisk) and the rectum (star).
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fig1
An emergency computed tomography (CT) revealed diffuse dilatation in proximal to mid ileal loop with abrupt luminal narrowing at distal ileum level without definite evidence of bowel ischemia (Figure 1).
Operative findings. The distal ileum is herniated into the defect of the Pouch of Douglas (arrow).
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fig2
During the operation, approximately 5 cm length of the distal ileum (45 cm from the ileocecal valve) had been herniated into a defect of the Pouch of Douglas, and there were no specific findings of pelvic examination (Figure 2).
After reduction of the herniated bowel, peritoneal defect between the uterus and the rectum is shown (arrow).
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fig3
After reduction of the herniated bowel that was incarcerated into a defect of the Pouch of Douglas, herniorrhaphy with primary sutures of the defect site was performed (Figure 3).