Presentation
Obese female. One day history of central abdominal pain. Clinicians suggests a mass. Cause?
Patient Data
Well defined small mass protruding through the anterior abdominal wall. The mass is tender to probe palpation.
On inspection peristalsis is present with a lumen containing fluid and semi-solid material.
A small loop of mid jejunum protrudes through a narrow defect in the anterior abdominal wall just superior to the umbilicus. A small amount of perienteric inflammatory change. Marked caliber change in the jejunum at the entrance through the hernia neck. The proximal small bowel is moderately dilated and fluid filled.
No free gas or free fluid.
Fibroid uterus.
Case Discussion
Not the typical general practitioner abdominal ultrasound scan. Despite the patients high BMI the small bowel was well visualized protruding through the anterior abdominal wall.
The paraumbilical hernia was manually reduced on the ward.
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