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Incarcerated femoral hernia due to foreign body

Case contributed by Ammar Haouimi
Diagnosis almost certain


Abdominal pain with distension, vomiting and painful swelling at the left groin.

Patient Data

Age: 80 years
Gender: Male

Distended small bowel with a transition point at the level of the left femoral canal where there is a small incarcerated femoral hernia containing a linear hyperdense foreign body (Fish bone) piercing the bowel wall with surrounding fat stranding. No extraluminal gas is seen.

Other findings:

  • mixed hiatal hernia

  • simple hepatic and renal cysts

  • epigastric hernia containing preperitoneal fat

Case Discussion

CT features most consistent with incarcerated left femoral hernia due to a foreign body perforating the bowel wall. At surgery, the foreign body was a fish bone which was confirmed later by the patient that was ingested accidentally 2 days ago.

Fish bone is considered one of the most common accidentally ingested foreign bodies. Usually eliminated without any complication. Gastrointestinal tract perforations are relatively rare (<1% of the cases) 1,2 and require surgery. CT is the best imaging modality to identify the nature and location of the ingested foreign body and its complications 1.

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