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Incarcerated femoral hernia causing high grade obstruction

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Several day history of abdominal discomfort, nausea and vomiting.

Patient Data

Age: 75 years
Gender: Female

High grade small bowel obstruction with gradual admixing of oral contrast with unspecified distal small bowel loops. Transition in the right lower quadrant at the site of femoral hernia, with contains a hairpin turn of mildly thickened small bowel. The hernia neck is below the origin of the inferior epigastric artery, passing under the inguinal ligament (linear ligament best seen on coronal images), and results in compression of the femoral vein (indicating a femoral hernia). 

Distal small bowel is decompressed.

Case Discussion

Femoral hernia resulting in high-grade small bowel obstruction. There may be some degree of strangulation (ischemia) given the mildly thickened appearance of the wall. The hernia neck is below the origin of the inferior epigastric artery and passing under the inguinal ligament, indicating that it is a femoral hernia. 

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