As you follow the small bowel from proximal -> distal, the small bowel contents are darker because they are fluid only and do not contain oral contrast. The use of oral contrast in this setting helps you to quickly find the transition point, because you can "jump ahead" to where the bowel contents are darkest (fluid only), rather than running the entire bowel.

The relationship of the hernia with the inguinal ligament and inferior epigastric vessels is key to appropriately classifying this as femoral hernia. It requires urgent surgical attention.

Case shared with me by Dr. Jeannine Ruby.