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Figure 4a.   Strangulated bowel obstruction due to an internal hernia in the lesser sac in a 50-year-old woman. (a) Contrast-enhanced CT scan shows bowel wall thickening with poor enhancement of the strangulated bowel segment (arrows) in the lesser sac. Regional mesenteric vascular engorgement and haziness are also seen. (b) Photograph of the resected specimen shows diffuse dark discoloration of the ischemic segment of the intestine.