Incarcerated femoral hernia

Case contributed by Dr Bruno Di Muzio

Presentation

Diffuse abdominal pain and distension.

Patient Data

Age: 80 years
Gender: Female
X-ray

Abdominal radiographs

There is small bowel distension with air-fluid levels; the large bowel is non-distended and there is no air seen in the rectum. Findings are in keeping with a small bowel obstruction. No pneumoperitoneum.
CT

CT Abdomen and pelvis

There is a right femoral hernia with the incarceration of the distal ileum causing upstream small bowel obstruction with air-fluid levels. The bowel otherwise enhances normally and there are no signs of bowel perforation. There is a small amount of free fluid in the peritoneal cavity. The colon has unremarkable appearances. The liver, pancreas, adrenal glands, and spleen are unremarkable. Both kidneys have normal size and enhancement, with a few bilateral simple cortical cysts. No intra abdominal lymphadenopathy. No suspicious bone lesions. The lung and pleural bases are clear.

Annotated image

Typical features of femoral hernia: the hernia exits below the inguinal ligament, medial to the femoral vein (blue dashed circle), and caudal to the emergence of the inferior epigastric vessels (green dashed circle on the coronal view). Go back to the CT scan scroll through to identify these structures. 

Case Discussion

Right femoral hernia incarcerated small bowel loop (the hernia exits below the inguinal ligament, medial to the femoral vein, and caudal to the emergence of the inferior epigastric vessels).

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Case information

rID: 56941
Case created: 30th Nov 2017
Last edited: 4th Dec 2017
Inclusion in quiz mode: Included

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