Images in Radiology
Intradural Small Bowel Herniation
Radiology 2022; 000:1–2 • https://doi.org/10.1148/radiol.220015

Images in 38-year-old woman with Marfan syndrome who was diagnosed with intradural small bowel herniation through a torn right S1 dural ectasia. (A) Oblique global illumination rendering of abdominal CT scan after semiautomatic segmentation of the enlarged afferent small bowel (*). The hernia orifice (arrowheads) separates the peritoneal cavity and the intradural space. (B, C) T2-weighted MRI scans in (B) axial and (C) sagittal planes show the herniated loop (arrowheads in B) of small bowel (* in B) ascending at L5-S1 (arrows), causing significant compression of the adjacent cauda equina nerve roots. (D)Intraoperative photograph of the incarcerated intestine with signs of distress (arrows). (E) Intraoperative photograph (anterior view) shows the hernia orifice in the sacrum (arrowheads).