Pediatric small bowel obstruction from incarcerated inguinal hernia

Case contributed by Laughlin Dawes
Diagnosis almost certain

Patient Data

Age: 3 months
Gender: Male

Dilated loops of bowel centrally with a lucent loop of bowel noted projecting in the left inguinal region. 

Conclusion: Intestinal obstruction caused by irreducible left inguinal hernia.

Case Discussion

Incarcerated hernias (constricted but not necessarily strangulated) occur when the contents of a hernia sac cannot be reduced into the abdominal cavity. Incarcerated hernias can be inguinal, femoral, or umbilical. The vast majority of inguinal hernias in children are indirect. Incarceration represents the most common complication associated with inguinal hernias, the incidence could be as high as 30% for infants younger than 2 months. Femoral hernias, which tend to incarcerate, are extremely rare in children and are the only hernias that occur in females more often than males. Umbilical hernias are very common in children but rarely incarcerate and often close spontaneously by age 5 years.

Credit: Dr Ahmed Haroun.

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