Presentation
Previous hysterectomy. Now abdominal mass.
Patient Data
There is a wide necked right lower quadrant incisional hernia containing multiple distal small bowel loops. The neck measures 3.5 cm in width and 3.9 cm in craniocaudal length. There is no evidence of a proximal small bowel obstruction. Mild stranding of the mesentery noted at the neck of the hernia.
Additionally, the small bowel mesentery is somewhat hazy and plump, and contains a number of soft tissue nodules are largest which measures 25 x 10 x 9 millimeters. These nodules is surrounded by a halo of non stranded fat.
The liver, spleen, adrenals, kidneys and pancreas appear unremarkable. No ascites. No enlarged lymph nodes identified in the abdomen. Cholecystectomy clips.
Case Discussion
Large incisional hernia through previous hysterectomy scar, and probably mesenteric panniculitis.
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