Small bowel obstruction secondary to femoral hernia
Severe abdominal pain and distension raised WCC, complex abdominal history, ventral hernia, Hartmanns, diverticulitis ? SBO ? intra abdominal sepsis.
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A right-sided femoral hernia contains a loop of small bowel. There is associated proximal small bowel dilatation, measuring up to 27 mm in diameter. No extraluminal free gas to suggest perforation. No features to suggest bowel ischemia.
Anterior abdominal wall hernia is noted containing a loop of small bowel, with the hernial orifice measuring approximately 21 mm in diameter. Surgical sutures are again noted in at the ileocecal junction and at the rectosigmoid junction in keeping with previous surgery. Divarication of the rectus abdominous muscles are again noted, with the transverse colon protruding into the anterior abdominal wall defect.
Small bowel obstruction due to right femoral hernia. No evidence of bowel ischemia or perforation.
Note the close proximity of the hernia sac to the common femoral vein which is indented.