Presentation
Abdominal pain.
Patient Data
Dilated large and small bowel extending to the level of the distal colon.
Indirect left inguinal hernia extending into the left scrotum containing bladder, sigmoid colon with its mesentery, and fluid with distal large bowel obstruction but no findings such as bowel wall thickening to suggest ischemia.
The annotated image shows the hernia sac displacing the inferior epigastric artery medially, indicating that this is an indirect hernia.
Case Discussion
The patient was taken to the operating room and the hernia sac was excised. This was an indirect hernia, the left inferior epigastric artery is displaced medially. Inguinal hernias are much more common in men than women. Indirect hernias are more common than direct hernias, which displace the inferior epigastric artery laterally.