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Congress: ECR25
Poster Number: C-27296
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-27296
Authorblock: F. Moliterni1, L. Luppi1, R. Milieri1, G. M. Astuti1, F. Costantino1, A. Zavatta1, M. Pedretti1, P. E. Orlandi2, M. Imbriani2; 1Bologna/IT, 2BOLOGNA/IT
Disclosures:
Fabio Moliterni: Nothing to disclose
Lisa Luppi: Nothing to disclose
Rocco Milieri: Nothing to disclose
Giovanna Maria Astuti: Nothing to disclose
Federica Costantino: Nothing to disclose
Andrea Zavatta: Nothing to disclose
Matteo Pedretti: Nothing to disclose
Paolo Emilio Orlandi: Nothing to disclose
Michele Imbriani: Nothing to disclose
Keywords: Abdomen, Emergency, Small bowel, Conventional radiography, CT, Ultrasound, Diagnostic procedure, Acute, Education and training, Hernia
Learning objectives To assist junior radiologists in accurately interpreting imaging findings in cases of intestinal obstruction caused by internal hernias (IH), and to guide them through the entire diagnostic process, with the ultimate goal of achieving an early and accurate diagnosis.
Read more Background An IH is defined as the protrusion of part of the intestinal viscera through openings, recesses, or fossae within the peritoneal cavity, resulting from congenital, post-traumatic, or post-surgical modifications of the normal peritoneal anatomy. IH are divided following the traditional Welch classification  into various subtypes based on the topographic distribution of herniated bowel loops in relation to the anatomic location of the orifice: Paraduodenal hernias: classically considered the most common type of IH with left-sided hernias being the most common subtype....
Read more Findings and procedure details Internal hernias represent a complex pathological entity with a subtle and often confusing clinical presentation, making radiologist’s role crucial in accurate patient assessment. As with many acute abdomen cases, ultrasound (US) and conventional radiography are typically the first-line imaging techniques, especially in the emergency setting, with CT often being considered only at a later stage of the diagnostic process.Conventional radiology and/or US may show unspecific signs of small bowel obstruction, such as dilated bowel loops with enlarged walls and intraperitoneal...
Read more Conclusion Internal hernias present a significant challenge for inexperienced radiologists. Understanding the entire diagnostic process, from initial imaging techniques to CT evaluation, can greatly enhance the ability to make accurate assessments, ultimately benefiting patient well-being.
Read more References Lanzetta MM, Masserelli A, Addeo G, Cozzi D, Maggialetti N, Danti G, Bartolini L, Pradella S, Giovagnoni A, Miele V. Internal hernias: a difficult diagnostic challenge. Review of CT signs and clinical findings. Acta Biomed. 2019 Apr 24;90(5-S):20-37. doi: 10.23750/abm.v90i5-S.8344. PMID: 31085971; PMCID: PMC6625567.Kelahan L, Menias CO, Chow L. A review of internal hernias related to congenital peritoneal fossae and apertures. Abdom Radiol (NY). 2021 May;46(5):1825-1836. doi: 10.1007/s00261-020-02829-4. Epub 2020 Oct 30. PMID: 33128101.Murali Appavoo Reddy UD, Dev B, Santosham...
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