“…Furthermore, that ileal loop had thickened wall, decreased contrast enhancement with perivisceral fluid: these signs are suggestive of vascular suffering. On the base of these findings was performed the suspect of an internal hernia in the site of falciform ligament [17] , [18] , [19] , [20] . Nevertheless, because of the preoperative diagnosis is very difficult, laparoscopic approach is mandatory and superior to other diagnostic tools, infact in up to 40% of patients it also can correct an erroneous preoperative diagnosis and exclude other abdominal pathological phenomena; plus the laparoscopic approach allows therapeutic correction of the defect during the same intervention [14] .…”