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CT of Internal Hernia Through a Peritoneal Defect of the Pouch of Douglas

Yutaka Inoue1,2, Takashi Shibata3 and Takeshi Ishida1

1 Department of Radiology, Toyonaka Municipal Hospital, 4-14-1 Shibahara-Cho, Toyonaka, Osaka 560-0055, Japan.
2 Present address: Department of Radiology, Sakai City Hospital, 1-1-1 Minamiyasui-cho Sakai, Osaka 590-0064, Japan.
3 Department of Surgery, Toyonaka Municipal Hospital, Osaka 560-0055, Japan.



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  		Fig. 1A. —80-year-old woman who presented with small-bowel obstruction and herniation of small-bowel loops in pouch of Douglas. CT scan of abdomen shows dilatation of small-bowel loops and decompressed colon.

 


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  		Fig. 1B. —80-year-old woman who presented with small-bowel obstruction and herniation of small-bowel loops in pouch of Douglas. CT scan obtained at level of pelvic floor shows cluster of collapsed small-bowel loops (arrows) in peritoneal pocket below pouch of Douglas between rectum (arrowhead) and uterine cervix (star).

 


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  		Fig. 1C. —80-year-old woman who presented with small-bowel obstruction and herniation of small-bowel loops in pouch of Douglas. Enteroclysis performed through long intestinal tube discloses abrupt narrowing (large arrow) of small bowel and cluster of small-bowel loops (small arrows) in peritoneal pocket anterior to air (arrowheads) in rectum.

 

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