Incarcerated para-umbilical hernia
65 years old patient with long history of ventral abdominal wall hernia and recent abdominal pain and distention.
Loading Stack -
0 images remaining
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.
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.