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Combined Transmesocolic–Transomental Internal Hernia

¹ All authors: Department of Radiology, Chi Mei Medical Center, 901 Chung Hwa Rd., Tainan 71010, Taiwan, Republic of China.

View larger version (116K): [in a new window]   Fig. 1A. —17-year-old girl with combined transmesocolic and transomental internal hernia. Contrast-enhanced CT scan reveals convergence of herniated mesenteric vessels and normal main trunks of superior mesenteric vessels. This converging point represented defect in gastrohepatic ligament (lesser omentum). Gastric upper body and antrum were on left and right sides of converging vessels, respectively. CHV = convergence of herniated mesenteric vessels, SMv = superior mesenteric vessels, GUB = gastric upper body, GA = gastric antrum, PTC = proximal transverse colon, DTC = distal transverse colon.

View larger version (110K): [in a new window]   Fig. 1B. —17-year-old girl with combined transmesocolic and transomental internal hernia. Contrast-enhanced CT scan obtained at level 3 cm caudad to A shows herniated mesenteric vessels coursing, ventral to stretched gastric lower body, to lower peritoneal cavity. HV = herniated mesenteric vessels, GLB = gastric lower body.

View larger version (106K): [in a new window]   Fig. 1C. —17-year-old girl with combined transmesocolic and transomental internal hernia. Contrast-enhanced CT scan obtained at level 2 cm caudad to B shows herniated small bowel was ventral to transverse colon (TC).

View larger version (40K): [in a new window]   Fig. 2A. —Diagrams show three levels (dotted lines) corresponding to levels shown in Figures 1A (A), 1B (B), and 1C (C). and B, Diagrams of coronal (A) and sagittal (B) views depict different levels at which CT scans in Figure 1A, 1B, 1C were obtained. LO = lesser omentum, TMC = transverse mesocolon, S = stomach, TC = transverse colon. PTC = proximal transverse colon, DTC = distal transverse colon, PSB = proximal small bowel, DSB = distal small bowel, GCL = gastrocolic ligament, GO = greater omentum.

View larger version (35K): [in a new window]   Fig. 2B. —Diagrams show three levels (dotted lines) corresponding to levels shown in Figures 1A (A), 1B (B), and 1C (C). Diagrams of coronal (A) and sagittal (B) views depict different levels at which CT scans in Figure 1A, 1B, 1C were obtained. LO = lesser omentum, TMC = transverse mesocolon, S = stomach, TC = transverse colon. PTC = proximal transverse colon, DTC = distal transverse colon, PSB = proximal small bowel, DSB = distal small bowel, GCL = gastrocolic ligament, GO = greater omentum.

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