Strangulated umbilical hernia

Case contributed by Dr Chris O'Donnell

Presentation

Acute painful swelling in the umbilicus with clinical irreducibility.

Patient Data

Age: 70
Gender: Male
CT

Small umbilical hernia containing fat. Note the narrow hernial neck and soft tissue swelling in the fat of the hernial sac.

Case Discussion

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.

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Case information

rID: 37192
Case created: 28th May 2015
Last edited: 21st Nov 2015
Inclusion in quiz mode: Included

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