Strangulated umbilical hernia
Acute painful swelling in the umbilicus with clinical irreducibility.
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Small umbilical hernia containing fat. Note the narrow hernial neck and soft tissue swelling in the fat of the hernial sac.
We as radiologists are often asked by clinicians to assess for an incarcerated hernia on CT. Incarceration means confined or imprisoned thus with a hernia means irreducible. This is a clinical diagnosis. What the clinicians really want to know is if there is a mechanical bowel obstruction associated with the hernia and/or if there is evidence of strangulation, i.e. constriction to the vascular supply of the hernial sac contents at the level of the neck. In this case there is apparent inflammation in the herniated fat strongly suggesting that strangulation is present.