A case of internal hernia after distal gastrectomy/Billroth II construction

We report a case of internal hernia after distal gastrectomy/Billroth II construction. CT showed dilated small bowels with medial and caudal displacement of the splenic flexure. In early phase of dynamic CT, dilated small bowels showed poor enhancement. These imaging findings, in combination with the patient history, was diagnostic for internal hernia with small bowel strangulation. Patients with internal hernias often die because diagnosis is difficult. It is important to be aware of the distinctive CT findings of these hernias.