Small bowel obstruction due to incarcerated paraumbilical hernia

Case contributed by Safwat Mohammad Almoghazy
Diagnosis certain

Presentation

A known case of rectal carcinoma and paraumbilical hernia presented with an irreducible hernia and symptoms of small bowel obstruction.

Patient Data

Age: 65 years
Gender: Male

Paraumbilical hernia with small bowel loops containing afferent loop which is dilated proximally until the stomach and collapsed efferent loop. The distal small and large bowel are collapsed.

The bowel walls are enhancing with evidence of mildly 'smudged' fat with no free fluid in the hernial sac suggestive of incarcerated bowel. 

Case Discussion

In developed countries, adhesions are by far the most common cause of small bowel obstruction, accounting for ~75% of obstructions, while in developing countries, incarcerated hernias are much more common accounting for 80% of obstructions.

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