Patient was posted for urgent operation. Intra-operative findings were of strangulated bowel loops. A resection and primary anastomosis was done.
This case clearly shows the importance of ultrasound in making the diagnosis of strangulation in the setting of irreducible hernia. Being non-invasive and readily available in the emergency department, this makes it advantageous over other imaging modalities in prompt surgical decision making.
Ultrasound features suggestive of bowel strangulation within a hernia sac are:
- thickening of the hernial sac
- presence of hyperechoic fat
- fluid within the sac
- dilated bowel within the sac
- oedamatous thick bowel walls
- loss of peristalsis