Incarcerated para-umbilical hernia

Case contributed by Dr Amr Farouk

Presentation

65 years old patient with long history of ventral abdominal wall hernia and recent abdominal pain and distention.

Patient Data

Age: 65 years old
Gender: Male

A para-umbilical hernia is seen with a 4.5 cm abdominal wall defect ,narrow neck & larger herniating sac harboring omentum and a bowel loop with proximal  intestinal obstructive changes and smudging of the herniating omentum is seen as well.

No CT evidence of bowel perforation or pneumo-peritoneum.

Case Discussion

Signs of intestinal obstruction with transition zone at the hernial sac showing proximal small bowel dilatation and distal collapse together with herniated omentum inflammatory changes makes the diagnosis of incarcerated hernia the cause of intestinal obstruction. This was confirmed in surgery.

The event of a sudden increase in intra-abdominal pressure, the hernial contents are squeezed through a narrow hernia sac neck into the sac. The subsequent recoil of sac neck entraps the hernial contents, preventing them from returning into the abdomen, and incarcerated hernia occurs.

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Case information

rID: 47844
Case created: 5th Sep 2016
Last edited: 14th Sep 2016
Inclusion in quiz mode: Included

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