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Abdomen » Gastrointestinal
Incarcerated inguinal hernia with bowel loop obstruction
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Author(s) :
Taco Geertsma, MD
 
Presentation 85 year old female patient with severe abdominal pain. There is also a small palpable mass in the left groin
 
 
 
Caption: Longitudinal image of the left lower abdomen and left groin
Description: Dilatated small bowel loop and an inguinal hernia
 
 
 
Caption: Longitudinal image of the left lower abdomen
Description: Dilatated fluid filled jejunal loops
 
 
 
Caption: Transverse image of the lower abdomen
Description: Dilatated fluid filled jejunal loops
 
 
 
Caption: Transverse image of the left groin
Description: Inguinal hernia with a fluid filled bowel loop
 
 
 
Caption: Transverse image of the left groin with compression
Description: Compression of the inguinal hernia has little effect
 
Final Diagnosis Incarcerated inguinal hernia with bowel loop obstruction
 
Discussion

 

There is a small bowel ileus with dilatated fluid filled bowel loops. In the left groin there is an inguinal hernia with a fluid filled small bowel loop. There is no significant effect during compression suggesting a nonreducible inguinal hernia. The first image shows a dilatated bowel loop proximal to where the loop enters the inguinal hernia.  

Signs of an incarcerated hernia are

-Thickening of the wall of the herniated bowel loop
-Fluid in the herniated bowel loop
-Free fluid in the hernia sac
-Intra abdominal bowel dilatation.

For more examples of inguinal hernia and small bowel pathology visit www.ultrasoundcases.info

 
Case References

 

Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N, Gotwald T, Frass R, Schneider B. Abdominal wall hernias: cross-sectional imaging signs of incarceration determined with sonography. AJR Am J Roentgenol. 2001 Nov;177(5):1061-6.

 
Follow Up The patient was operated and the diagnosis incarcerated inguinal hernia with bowel loop obstruction was confirmed
 
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