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Figure 6. An 80-year-old man presented with nausea and vomiting with diffuse abdominal tenderness. (a) Contrast-enhanced CT at the pelvis shows numerous dilated small bowel loops (black arrows) one of them with a transition zone (long white arrow) as well as collapsed distal loops (thick white arrow). (b) 1.3 cm caudally, another transition zone of a dilated loop is seen adjacent to that seen in (a) (white arrow) compatible with an entrapped loop within an internial hernia. (c) At the level of the urinary bladder (B), the thickened-wall of the incarcerated small bowel loop is clearly demonstrated (arrows) with adjacent fluid and mesenteric fat infiltration. At laparotomy, a gangrenous incarcerated ileal loop was found within a paravesical hernia. Small bowel resection with ileo-ileal anastomosis and hernial repair were performed.
