Small bowel obstruction due to inguinal incarceration

Case contributed by Dr Bruno Di Muzio

Presentation

Acute onset of epigastric pain.

Patient Data

Age: 80-year-old
X-ray

Abdominal radiographs

Abdominal radiographs showing small bowel dilation with air-fluid levels within. Metallic clips in the pelvis inferring previous inguinal surgery. 

CT

CT Abdomen and pelvis.

Small bowel dilation is present until the protrusion of a segment of distal ileum into the right inguinal hernia (probably indirect inguinal hernia). Metallic surgical clips within both inguinal regions are in keeping with previous surgery for hernia. Small diverticula scattered through the colon with no evidence of acute inflammation. Bowel is otherwise unremarkable. No evidence of free fluid or free gas in the abdomen. Segment I hepatic simple cyst measuring 1.8 cm, liver is otherwise unremarkable. The gallbladder, pancreas, spleen, and adrenal glands have normal appearances. Kidneys have normal size and enhancement, showing bilateral cortical cysts. No hydronephrosis. Prostate is diffusely enlarged. No lymph node enlargement. No suspicious bone lesions. Pleural bases are clear. 

Case Discussion

Case illustrating typical features of a mechanical small bowel obstruction due to right inguinal incarceration.

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Case information

rID: 47555
Case created: 21st Aug 2016
Last edited: 5th Sep 2016
Tag: rmh
Inclusion in quiz mode: Included

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