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Femoral hernia

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Acute onset of left inguinal swelling, developed overnight. History of left sided hernia repair 15 years ago.

Patient Data

Age: 80 years
Gender: Male
ultrasound

Small bowel loop is noted in the hernial sac with surrounding fluid. The hernial neck measures 4 mm.

Vascularity is preserved in the herniated segment.

Intraperitoneal segment of small bowel shows wall thickening (5 mm).

No dilatation of small bowel loops in abdomen.

Case Discussion

The patient was taken to theater and a femoral hernia was diagnosed (thought to be an inguinal hernia on the pre-operative ultrasound). Part of bowel wall was in the sac. Because the surgeon had doubt about origin of hernia, the incision was made directly over the site of swelling.

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