25% of men and 2% of women develop inguinal hernias in their lifetime. The more commonly reported complications of unrepaired inguinal hernias include incarceration and strangulation of intestinal structures that are trapped in the hernial sac.

Intestinal loops trapped inside a hernia are susceptible to perforation. On CT, bowel perforation is suspected with the presence of free intraperitoneal air or free fluid, as is demonstrated in this case. 

CT findings of intestinal incarceration or strangulation with perforation may include: 

• extravasated oral contrast material
• bowel wall thickening
• bowel wall enhancement
• bowel wall discontinuity