Landzert's fossa is behind the descending mesocolon, left of the fourth part of the duodenum, posterior to the peritoneal fold associated with the inferior mesenteric vein and ascending left colic artery. The hernia may be located between the stomach and pancreas, or behind the tail of the pancreas, or between the transverse colon and left adrenal gland.
Contents: duodenum and proximal jejunum
Clinical features:
(1) small bowel obstruction with vomiting
(2) volvulus or intussusception
(3) long-term indigestion or periodic cramps
(4) abdominal distention
(5) postprandial pain that is relieved by a postural change
CT findings:
(1) encapsulated cluster of dilated bowel loops with a sac-like appearance in the LUQ
(2) the inferior mesenteric vein is at the anterior border and the left colic artery is at the medial border
(3) stretching and displacement of mesenteric vessels
(4) anterior displacement of the stomach
(5) air-fluid levels with small bowel obstruction
