Left paraduodenal hernia causing closed loop low grade small bowel obstruction.

A cluster of dilated small bowel loops (proximal jejunal loops), abnormally positioned in the left anterior pararenal space, demonstrating multiple air fluid levels with surrounding mesenteric fat stranding – suggestive of Left paraduodenal hernia causing closed loop low grade small bowel obstruction.

The inferior mesenteric vein is traversing anteromedial to the clustered bowel loops

No evidence of intramural air. No evidence of bowel ischemia

Trace free fluid in bilateral paracolic spaces, lower abdomen.

A solitary gall bladder calculus