FIGURE 1.

The observed intraoperative anatomic abnormalities and configurations of duodenum, small intestine, and large bowel. Note tethering of the duodenum anteriorly with the uncinate process and posteriorly between inferior pancreatic surface and retroperitoneal cava (A). In a patient with repaired duodenal atresia at birth, the liver grew over the anterior duodenal wall (B) and another patient with proximal jejunum herniating into a missed diaphragmatic defect (C). Internal hernia with cocoon encasement was discovered in 3 patients with situs-inversus (n=1) and redo Ladd's procedure (n=2) (D). A very convoluted transverse colon with contracted mesentery and left colon with a floppy mesenteric attachment were common findings (E ). Note sagging of descending and sigmoid colon into the pelvic cavity.