case_images: PMC10781936_01
case_images: CT AP post oral and intravenous contrast; (a) coronal view and (b) axial view showing multiple mildly dilated small bowel loops, suspicious for developing SBO, with transition point in the right lower pelvis, where there is possible focal mural thickening, and no perforation; the appendix appeared normal.
case_images: rjad718f1.jpg
case_images: PMC10781936_01_rjad718f1.jpg
case_images: f1
case_images: Intraoperative laparoscopy findings, and (a) key landmarks including the uterus and right ovary are identified, as well as a short segment of small bowel diving deep into the pelvis, and there is also moderate volume of serous free fluid; (b) serous fluid has been suctioned and there is small bowel herniating through a small peritoneal defect adjacent to the rectum on the right represented by the red arrow; (c) peritoneal defect in the POD; (d) the short segment of small bowel that was involved incarcerated in the hernia has a small area of bruising but is otherwise viable, and (e) the peritoneal defect was repaired with a single figure of 8 stich using 0 PDS suture.
case_images: rjad718f2.jpg
case_images: PMC10781936_01_rjad718f2.jpg
case_images: f2
case_images: Intraoperative findings are demonstrated in Fig. 2. There was a finding of a nubbin of small bowel herniating through a small peritoneal defect at the peritoneal reflection adjacent to the rectum on the right and moderate serous free fluid was identified (Fig. 2a-c). The short segment of small bowel which was incarcerated within the hernia was bruised as shown in Fig. 2d but viable.