Small bowel obstruction due to left inguinal hernia

Case contributed by Vikas Shah
Diagnosis certain

Presentation

Vomiting and abdominal distension. Known left groin hernia.

Patient Data

Age: 75 years
Gender: Male

Abdominal x-ray

x-ray

Multiple gas-filled and distended loops of small bowel noted centrally. No pneumoperitoneum. Multiple calcified stones within the pelvis to the left of the midline.

Zoomed: dilated small bowel

Folds running across the diameter of the centrally-positioned bowel, indicating that this is small bowel as opposed to large bowel. The folds are called the valvulae conniventes.

CT abdomen and pelvis

ct

Nasogastric tube in situ. Calcified stones in catheterized urinary bladder.

Small bowel obstruction caused by entrapment in a left inguinal hernia. No perforation and no fluid collection.

Right middle and lower lobe opacification, and left lower lobe confluent opacification/collapse.

Case Discussion

Dilated small bowel loops seen on AXR, with the CT confirming small bowel obstruction due to left inguinal hernia.

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