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PMC6462366_02
erect radiograph of the abdomen showing dilated small bowel loops with some air-fluid levels
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Plain abdominal X-ray in an erect position showed air-fluid levels of the small bowel loops in the upper abdomen (Figure 1).
axial enhanced abdominal CT scan shows a cluster of jejunal loops in the Landzert's fossa
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Abdominal CT scan was interpreted as an ileal obstruction associated with retractile mesenteritis around a hypervascularized pseudomass (Figure 2).
intra-operative view of the hernia sac. This image shows the Landzert's fossa (empty), bounded by the first jejunal loop up and the neck of the sac around
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Therefore, we decided to perform an emergency laparotomy which revealed that the proximal jejunum was prolapsed within a sac-like structure projected to the left of the midline (Figure 3).
the hernia sac removed
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The peritoneal sac was resected (Figure 4).