Presentation
Left iliac fossa pain. Past history of diverticular disease.
Patient Data
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Small bowel obstruction secondary to left femoral hernia. The loop that is within the hernia is thickened but with normally enhancing wall. The hernia compresses the femoral vein, axial, coronal.
Perihepatic and left paracolic gutter free fluid. No free gas.
Extensive colonic diverticular disease. Within liver segment six and four are subcentimeter hypodensities which are too small to characterize.
Conclusion:
Small bowel obstruction secondary to left femoral hernia. Evidence of early ischemia within the entrapped small bowel loop.
Case Discussion
This is an example of an incarcerated femoral hernia resulting in a small bowel obstruction with early ischemic changes of the incarcerated loop. This hernia can be differentiated from an inguinal hernia because its origin is below that of the inferior epigastric vessels and it lies as a close medial relation of the femoral vein.