Case 257

 We present a seventy eight-year-old female for abdominal pain. She felt intermittent abdominal pain from last evening and entered bathroom for soft stools approximately ten times. This morning, she visited to a local clinic by bicycle since taking a walk made her pain radiating. She was introduced to our hospital for suspicious peritonitis. She agreed to take abdominal CT for further investigation (Figs.1-4). Laboratory test revealed eGFR 53.9 ml/min/1.73L, LDH 217 U/l, CPK 139 U/l, white blood cells 8180/mm3, leukocytes69.1%, D dimer 1.70 μg/ml.

What is your imaging diagnosis ?

1.　Mesenteric internal hernia

2.　Sigmoid mesocolon internal hernia

3.　Strangulation hernia

4.　Adhesion hernia due to post sigmoid diverticulitis

5.　Small bowel obstruction due to Meckel diverticulum with string

answer

2022.2.15