Hooking Intestine Sign: a Typical Diagnostic CT Finding of Petersen's Hernia

Overview

Journal Jpn J Radiol

Publisher Springer

Specialty Radiology

Date 2017 Oct 18

PMID 29039111

Citations 2

Authors

Wataru Yamashita

Kenji Nishida

Shuichi Kawada

Kouichi Mori

Shinsuke Usui

Jun Oyama

Akira Toriihara

Ukihide Tateishi

Affiliations

Soon will be listed here.

Abstract

Purpose: To clarify typical diagnostic computed tomography (CT) findings of Petersen's hernia for differentiation from other causes of internal hernia observed in patients having undergone gastrectomy with Roux-en-Y gastric bypass.

Methods: We retrospectively reviewed CT findings of internal hernia in patients who had undergone both gastrectomy and Roux-en-Y reconstruction and a second surgery for bowel obstruction. Thirteen patients with Petersen's hernia and 6 with internal hernia other than Petersen's hernia were investigated. Six CT findings, viz. whirl sign, mesenteric fat haziness, intestinal distension in the upper abdomen, herniated intestinal loop above the gastric level, middle/distal ileum courses downwards from the left hypochondrium, and hooking intestine sign, which means two or more intestines pass through the inner side of J-shaped vessels consisting of mesenteric vessels of the elevated jejunum, were scored and evaluated regarding their diagnostic performance.

Results: The hooking intestine sign showed the highest sensitivity, specificity and accuracy (100%, 100% and 100%). We could detect J-shaped vessels in all Petersen's hernia patients. Inside the J-shaped vessels there were two or more intestinal tracts passing through in the Petersen's hernia group. There was only transverse colon inside the J-shaped vessels in the control group.

Conclusion: The hooking intestine sign may be useful for diagnosing Petersen's hernia on CT.

Citing Articles

Prediction of the possibility of laparoscopic reduction of Petersen's hernia after gastrectomy: multicenter observational cohort study.

Min J, Park J, Bae K, Yoon K, Kim T, Jung E Wideochir Inne Tech Maloinwazyjne. 2021; 16(3):543-551.

PMID: 34691304 PMC: 8512502. DOI: 10.5114/wiitm.2021.103964.

Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery.

Shin C, Kim S Korean J Radiol. 2020; 21(7):793-811.

PMID: 32524781 PMC: 7289697. DOI: 10.3348/kjr.2019.0822.

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