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Small bowel obstruction secondary to incisional hernia

Case contributed by Vikas Shah
Diagnosis certain

Presentation

Vomiting, abdominal pain and distension. Previous anterior resection.

Patient Data

Age: 70 years
Gender: Female

Study performed without intravenous contrast due to acutely impaired renal function.

Small bowel obstruction is present, secondary to entrapment in an anterior abdominal wall hernia. The hernia neck and sac are small, and located just to the right of the midline, just above the level of the right superior pubic ramus. No free gas.

Incidental findings of indeterminate lesion arising from lower pole of right kidney and a cystic lesion in the pancreatic head/neck.

Case Discussion

The hernia neck was at the site of a scar, defining this as an incisional hernia. It was successfully reduced and repaired. Subsequent contrast enhanced imaging to evaluate the pancreatic and renal lesions has not been performed.

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