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October 2008

Structure in the abdominal wall
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Clinical information

Obese patient with abdominal pain and a palpable mass in the midline of the upper abdomen

Ultrasound Images & Clips

74 year old male, Obese patient with abdominal pain and a palpable mass in the midline of the upper abdomen

The mass consists of fluid filled ring like structures
The mass consists of fluid filled ring like structures
Longitudinal image of one of these ring-like structures shows a small bowel loop filled with fluid and sedimentation of bowel contents
Longitudinal image of one of these ring-like structures shows a small bowel loop filled with fluid and sedimentation of bowel contents
There is fluid around the bowel loops. There is also slight thickening of the bowel wall.
There is fluid around the bowel loops. There is also slight thickening of the bowel wall.
The plain abdominal X ray shows a dilatated bowel loop in the midline of the upper abdomen
The plain abdominal X ray shows a dilatated bowel loop in the midline of the upper abdomen
High frequency image of the bowel loops. The dilatated bowel loops are not covered by the abdominal wall muscles, but converge to a defect in the abdominal wall muscle layer.
High frequency image of the bowel loops. The dilatated bowel loops are not covered by the abdominal wall muscles, but converge to a defect in the abdominal wall muscle layer.
A lower frequency image shows an abdominal wall hernia through which small bowel loops protrude.
A lower frequency image shows an abdominal wall hernia through which small bowel loops protrude.
Detail of the abdominal wall hernia
Detail of the abdominal wall hernia

Conclusion

The patient was operated and the diagnosis non reducible epigastric hernia with incarcerated bowel loops was confirmed.

References            
Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N, Gotwald T, Frass R, Schneider B. Abdominal wall hernias: cross-sectional imaging signs of incarceration determined with sonography. AJR Am J Roentgenol. 2001 Nov;177(5):1061-6.

Details

  • Sex: Male
  • Age: 74

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photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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