case_images: PMC10907547_01
case_images: Right paraduodenal hernia. Axial sections of the CECT abdomen (A, B) show a cluster of dilated distal duodenal and proximal jejunal loops on the right side of the abdomen (yellow arrows). B: A few small bowel loops in the hernial sac show a small bowel feces sign (red arrows). Also note the dilated small bowel loops in the rest of the abdominal cavity (blue arrows).. CECT: contrast-enhanced computed tomography
case_images: cureus-0016-00000053342-i01.jpg
case_images: PMC10907547_01_cureus-0016-00000053342-i01.jpg
case_images: FIG1
case_images: Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis was done in the late arterial and portal venous phases after administration of intravenous contrast, which showed a pseudo-encapsulated cluster of dilated distal duodenal and proximal jejunal loops in the right hypochondrium and right lumbar region (Figure 1).
case_images: Whirlpool sign . Axial sections of the CECT abdomen in thin section (A) and maximum intensity projection (B) show a swirl of mesenteric vessels (yellow arrow) near the fossa of Waldeyer, indicative of the whirlpool sign.. CECT: contrast-enhanced computed tomography
case_images: cureus-0016-00000053342-i02.jpg
case_images: PMC10907547_01_cureus-0016-00000053342-i02.jpg
case_images: FIG2
case_images: Whirlpool sign and small bowel volvulus within the right paraduodenal hernial sac. Parasagittal (A) and curved planar reconstruction (B) sections of the CECT abdomen show a swirl of mesenteric vessels (yellow arrow) noted near the fossa of Waldeyer, indicating volvulus. B: Small bowel loops are noted entering and exiting the hernial sac (red arrow) causing closed-loop obstruction with volvulus.. CECT: contrast-enhanced computed tomography
case_images: cureus-0016-00000053342-i03.jpg
case_images: PMC10907547_01_cureus-0016-00000053342-i03.jpg
case_images: FIG3
case_images: Axis of superior mesenteric vessels and gut malrotation. Axial sections of the CECT abdomen show the maintained axis of the superior mesenteric artery (red arrow) and superior mesenteric vein (blue arrow). Jejunal loops are seen on the right side of the peritoneal cavity (black arrow) and ileal loops (yellow arrow) are seen on the left side of the peritoneal cavity.. CECT: contrast-enhanced computed tomography
case_images: cureus-0016-00000053342-i04.jpg
case_images: PMC10907547_01_cureus-0016-00000053342-i04.jpg
case_images: FIG4
case_images: Jejunal loops were predominantly on the right side and ileal loops were on the left side of the abdominal cavity with the normal position of caecum (Figure 4). The axis of superior mesenteric vessels was maintained (Figure 4).
case_images: Intraoperative images. A shows a glistening hernial sac containing the small bowel; B shows the neck of the hernial sac (black arrow). C shows the hernial sac (black arrow). D shows sac closure (white arrow) with superior mesenteric vessels (black arrow) seen posterior to the defect.
case_images: cureus-0016-00000053342-i05.jpg
case_images: PMC10907547_01_cureus-0016-00000053342-i05.jpg
case_images: FIG5
case_images: Superior mesenteric vessels were identified posterior to the defect (Figure 5).