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