Strangulated hernia with bowel ischemia
Elderly woman presented with a large hard and tender lump in anterior abdominal wall. History of abdominal surgery 25 years back.
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There is an anterior abdominal wall defect noted through which small bowel loops and omentum are protruding out of the abdominal cavity in a C-shaped configuration. The bowel loops involved in hernia show wall thickening. There is also mesenteric gas and bubble and band like pneumatosis. There is surrounding mesenteric fat stranding. There is mild amount of free fluid noted within the hernia sac. Constellation of these findings suggest strangulated hernia with bowel ischemia.
The bowel loops proximal to the hernia show gaseous dilatation and there is collapse of distal bowel loops noted.
Mild free fluid noted in the peritoneum.
MDCT with MPR is particularly useful tool in evaluation of complicated and uncomplicated bowel hernia.