Left sided hernia repair 15 years ago. Complaining of left inguinal swelling - acute onset (developed overnight).
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Small bowel noted in hernia with surrounding fluid. Vascularity was preserved in herniated segment. Hernia neck - 4 mm. Intraperitoneal segment of small bowel shows wall thickening - 5 mm. No dilatation of small bowel loops in abdomen.
The patient was taken to theater and a femoral hernia was diagnosed (thought to be an inguinal hernia on the pre-operative ultrasound). Part of bowel wall was in the sac. Because the surgeon had doubt about origin of hernia, the incision was made directly over the site of swelling.