Small bowel obstruction due to surgical hernia

Case contributed by Liter Nguri
Diagnosis certain

Presentation

Complain of a lump in the lower abdomen for a few months. History of abdominal sacrocolpopexy.

Patient Data

Age: 60 years
Gender: Female

The contrast-enhanced CT abdomen images show a midline defect of about 3.3cm in the hypogastric region with herniation of the peritoneal fluid, collapsed bowel loops, and mesentery into the subcutaneous plane. The small bowel loops (ileal loops) proximal to the herniated bowel are significantly distended and show air-fluid levels within. There is associated mesenteric inflammation adjacent to the herniated sac suggesting peritonitis.

Case Discussion

This case demonstrates the typical presentation of a surgical hernia causing small bowel obstruction. The patient was operated on the same day and hernia was reduced.  Intraoperatively viable ileal loops were found.

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