Small bowel obstruction due to an incarcerated femoral hernia

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Elderly female complaining of diffuse abdominal pain.

Patient Data

Age: 70 years
Gender: Female

Dilated distal small bowel, in keeping with small bowel obstruction.

Dilated fluid filled small bowel loops, down to a transition point in left groin.  A 'knuckle' of small bowel is incarcerated in a small left femoral hernia ( not detectable on clinical examination).

Foci of free air in the abdomen in keeping with perforated small bowel.

Case Discussion

Small bowel obstruction is common.  One of the more common causes is due to an abdominal wall hernia.

This is one of the very satisfying findings to aid the surgeon and the value of the CT scan, along with confirming the diagnosis and looking for a visceral perforation.

This patient underwent emergency surgery, confirming all of the above.

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