腹内疝CT表现文档

腹内疝CT表现CTimagesCTimagesWhichfindingsarepresent?

Venousthrombosis?Mesenterictwisting?Displacedbowelloops?×√√Whichfindingsarepresent?Withintheleftupperabdomen,thereisthinsacfilledwithsmallbowelwithswirlingvesselsidentifiedwithinit.

Whichchoiceisthemostlikelydiagnosis?A,

Paraduodenalhernia

B,ForamenofWinslowhernia

C,Transmesenterichernia

D,Transomentalhernia

E,CongenitalmalrotationParaduodenalHernia

What’sparaduodenalhernia

themostcommontypeofinternalhernia(53%)congenitalhernia,herniasacasymptomatic,colickyepigastricorperiumbilicalpainM:F=3:1hasleftandrighttwosubtypes,theformeraccountsforabout3/4HowparaduodenalherniahapenedLeftparaduodenalherniaoccurwhenbowelprolapsesthroughLandzert'sfossa,anaperturepresentinapproximately2%ofthepopulation.Landzert'sfossaislocatedbehindtheascendingorfourthpartoftheduodenumandisformedbytheliftingupofaperitonealfoldbytheinferiormesentericveinandascendingleftcolicarteryastheyrunalongthelateralsideofthefossa.HowparaduodenalherniahapenedRightsubtypeoccurwhenbowelprolapsesthroughWaldeyer'sfossabelowtotheascendingduodenum,andtotherightsideofthemesocolon.CTDiagnosis(Leftparaduodenalhernia

)CTDiagnosis(Leftparaduodenalhernia

)axialcontrast-enhancedCTscanin11-year-oldboyshowssmall-bowelloops(arrow)betweenstomachandpancreasCTDiagnosis(Leftparaduodenalhernia

)axialcontrast-enhancedCTscanin28-year-oldmanshowssmall-bowelloops(whitearrow)behindpancreas(P)(blackarrowindicatesstomach)CTDiagnosis(Leftparaduodenalhernia

)axialcontrast-enhancedCTscanin36-year-oldmanshowssmall-bowelloops(arrow)displayinginferiormenstericvein(arrowhead)toleft.CTDiagnosis(Leftparaduodenalhernia

)coronalconstructionofcontrast-enhancedCTin28-year-oldmanshowssmall-bowelloopsbetweentransversecolon(T)andleftadrenalgland(arrow)CTDiagnosis(Leftparaduodenalhernia

)CTscanofthemidabdomenshowstheinferiormesentericvein(arrowhead),thisvesselisalandmarkfortheinferiormesocolon.whichislocatedattheanteromedialborderoftheencapsulatedjejunalloops(J).Diagram(coronalview)ofthesurgicalfindingsshowsthatthefossaLandzertis4cmindiameter(arrowhead)CTDiagnosis(Leftparaduodenalhernia

)Mesentericvesselabnormalities,includingenlargement,stretching,andanteriordisplacementofthemainmesenterictrunks,especiallytheinferiormesentericvein,totheleft,alsoarehelpfulfindingsCTDiagnosis(Leftparaduodenalhernia

)contrast-enhancedCTscanoftheupperabdomenshowsasaclikemassofdilatedjejunalloops(J)betweenthepancreaticheadandstomach.thedilatedinferiormesentericvein(arrowhead)islocatedattheanteriorborderoftheencapsulatedloops.Crowedandengorgedmesentericvessels(arrow)atthefossaofLandzert(L).Unlikeherniasatothersites,thediagnosisofaninternalherniaismoredifficultbecausethesiteofdefectinthemesenteryisnotobviousonimaging.Thisisbecauseboththehernialorifice(occupiedbythemesenteryoftheherniatedloops)