UOTW #40

46 yo healthy male presents with slowly worsening left groin pain. The patient works in manual labor. On exam he is in mild distress and points to an area just lateral to his pubic symphysis, stating that he has an aching pain in that region that is worse as the day progresses. On physical exam, the vitals are normal except for mild tachycardia. No obvious bulge, swelling or skin changes seen over the area, and palpation does not elicit any obvious findings of a hernia, however suspicion still remains high. An ultrasound is brought into the room revealing the following images:

Answer

2 thoughts on “UOTW #40

  1. SUPRA PUBIC Hernia surrounded by peritoneal fluid. What appears to be Intestinal loop caution should be considered for Deminshed s or intermittent loss of blood flow in the intestional loop wall due to increased pressure against the bowel loop from adjacent abdominal wall.

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