title: Usefulness of Oblique Multiplanar Images on Multi-Detector Computed Tomography for Diagnosing Intersigmoid Hernia.
abstract: BACKGROUND
  Intersigmoid hernia is a hernia of the small intestine into the intersigmoid fossa. Because the cavity of the intersigmoid fossa is so small, the preoperative detection of incarcerated intestine and/or mesenteric convergence is very difficult. We report a case of intersigmoid hernia in which the incarcerated bowel and mesenteric convergence could be visualized by oblique multiplanar reconstruction (MPR) images on multi-detector computed tomography (MDCT).
  
  
  METHODS
  An 82-year-old man with small bowel obstruction was treated conservatively with a long intestinal tube. Axial plane images of MDCT detected only a thickening of the small bowel wall and a narrowing of the lumen in the pelvis. Since a fourteen-day waiting period did not improve the condition at all, he underwent surgery. The small bowel was herniated into the intersigmoid fossa. After surgery, we studied the preoperative images of MDCT once again. However, neither converged mesentery nor hernia orifice had been depicted. We attempted to make oblique coronal/sagittal MPR images using SYNAPSE VINCENT® and succeeded in visualizing not only the incarcerated bowels but also the hernia orifice and mesenteric convergence.
  
  
  CONCLUSIONS
  Creating oblique MPR images from the MDCT volume data would help in making a preoperative diagnosis of sigmoid mesocolon hernias such as intersigmoid hernia with increasing confidence.
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Masatake
authors.initials: M
authors.lastname: Iida
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kudoh
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uchinami
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamamoto
keywords: Intersigmoid hernia; Intestinal obstruction; Multi-detector computed tomography, MDCT; Multiplanar reconstruction, MPR