Presentation
Symptoms of small bowel obstruction.
Patient Data
Dilated, fluid-filled bowel loops (jejunal and proximal ileal loops) up to 3.2 cm. A sac-like cluster of distended small bowel loops with feces sign is noted in the right supa-and paravesical region, herniating through the supravesical fossa, and displacing the bladder to the left. Mild peritoneal effusion is seen.
Small umbilical hernia of epiploic content is noted.
Case Discussion
CT features of a right lateral paravesical internal hernia through the supravesical fossa with small bowel obstruction which was confirmed at surgery.
Paravesical internal hernias are an extremely rare form of internal hernias 2. Three categories are described anterior, right or left lateral, and posterior, depending on their position to the bladder 1.
Additional contributor: C. Boukaaba, MD
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