Omental infarct within inguinal hernia
Lower abdominal pain.
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A large volume of inflamed stranded intraperitoneal fat extends into the right iliac fossa and into the right inguinal canal, lateral to the inferior epigastric vessels (ie indirect inguinal hernia). This is associated with twisting of the omental vessels which is best appreciated on the axial images. No 'halo sign' evident.
The caecum is normally positioned however appears marginally thick walled and the terminal ileum similarly appears marginally thick walled.
The liver, spleen, pancreas, adrenal glands and kidneys are unremarkable. There is no free gas. There is minimal free fluid.
Appearances are in keeping with omental infarction with an associated fat containing right inguinal hernia.
It just so happens this patient also has an inguinal hernia containing the infarcting / infarcted ometum. Go figure.