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. 2015 Dec;77(Suppl 2):600-2.
doi: 10.1007/s12262-013-0938-9. Epub 2013 Jun 23.

Malrotation of Small Bowel-Diagnostic Computed Tomography (CT) Signs and Intraoperative Findings

S Rajesh  1 , P Sampath Kumar  1 , Gaurav Maheshwari  1 , Charudutt Sambhaji  1
Affiliations

Malrotation of Small Bowel-Diagnostic Computed Tomography (CT) Signs and Intraoperative Findings

S Rajesh et al. Indian J Surg. 2015 Dec.

Abstract

Right paraduodenal hernia usually occurs in setting of nonrotated small bowel, when small bowel herniates through Waldeyer's fossa (a defect in the first part of jejunal mesentery). It lies behind the superior mesenteric artery and inferior to the transverse colon or third portion of duodenum. We studied two cases of right paraduodenal hernia, an incomplete rotation, and nonrotation of small bowel, respectively, and describe CT abdomen signs, which can give a preoperative diagnosis.

Keywords: Incomplete rotation and nonrotation of small bowel; Right paraduodenal hernia.

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Figures

Fig. 1
Fig. 1
Compression of duodenum between SMA and aorta with dilated proximal duodenum
Fig. 2
Fig. 2
Showing Ladd's bands connecting the right colon and duodenum
Fig. 3
Fig. 3
Showing right paraduodenal hernia (large arrow) through mobile right mesocolon (small arrow) seen after releasing Ladd's bands
Fig. 4
Fig. 4
CT abdomen showing SMV lying on left ventral aspect of SMA suggesting nonrotation of small bowel
Fig. 5
Fig. 5
Duodenal third part (large arrow) going straight and downwards and colon (small arrow) on left side of abdomen
Fig. 6
Fig. 6
CT abdomen showing duodenum going towards right and downwards
Fig. 7
Fig. 7
CT abdomen showing inferior displacement of DJ (small arrow) as compared to duodenal cap (large arrow)
Fig. 8
Fig. 8
CT abdomen showing proximal jejunal arteries (arrow) reversing their direction to right
Fig. 9
Fig. 9
CT abdomen showing superior mesenteric artery and ileocolic branch (arrow) forming anterior margin of hernia. Small bowel traversing to left at the level of bifurcation of aorta
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