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Fig. 11A. —55-year-old man with history of right ureteral transitional cell carcinoma, now presenting with acute abdominal pain related to unsuspected malrotation with strangulated internal hernia. Axial unenhanced CT scan shows dilated bowel loops on right with pneumatosis (arrowheads) and gas (arrow) in superior mesenteric vein, strongly suggesting ischemic or necrotic bowel. Extensive small-bowel resection was required at surgery.