PMC7240054_01
CT scan of the abdomen: conglutinated ileal loops in the right iliac fossa.
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The abdominal CT scan revealed an conglomerate ileal loops with thickened walls filled of fluid in the right iliac recess (Fig. 1).
Endoscopic picture showing the fibrous band crossing the midline from the medial to right side anteriorly to ileum, with dilated incarcerated bowels.
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At laparoscopy (Fig. 2), the patient was found to have many visceral adhesions in right iliac fossa, small bowel distension, the complete absence of Treitz's ligament and an intestinal volvulus with edematous, necrotic ileal loop in malrotation, showing the presence of a band between the right colon and the liver which divided the ileal loops located at right of ascending colon (Fig. 3, Fig. 4) so we decided to perform open surgery.
Intraoperative image representing the fibrous band during small bowel adhesiolisis.
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At laparoscopy (Fig. 2), the patient was found to have many visceral adhesions in right iliac fossa, small bowel distension, the complete absence of Treitz's ligament and an intestinal volvulus with edematous, necrotic ileal loop in malrotation, showing the presence of a band between the right colon and the liver which divided the ileal loops located at right of ascending colon (Fig. 3, Fig. 4) so we decided to perform open surgery.
Intraoperative finding: Ladd's band.
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We performed the closure of the internal mesenteric passageway (Fig. 5, Fig. 6) then the resection of necrotic small bowel segment, the section of the fibrous band and the resection of Meckel diverticulum incidentally find on exploration.