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Fig. 6. —59-year-old woman with no history of surgery who presented with increasing abdominal pain. CT scan shows dilated small-bowel loops with diffuse wall thickening and coning of mesentery (arrowheads) at site of transition. Possibility of ischemia was considered on basis of CT appearance; emergent surgery revealed internal hernia through which large amount of ileum had prolapsed and volvulated. Ischemic necrosis was confirmed, and approximately 1.2 m of small bowel was resected.





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