Answers :
What can you see - there are two findings which should be noted ?
There is dilatation of the small bowel.
On the right side of the lower abdomen there is gas visible outside the abdominal wall. This is most likely to represent a hernia containing loops of bowel.
Do you think this patient needs surgery ?
If this hernia is irreducible there is a risk of obstruction as the bowel is trapped in the hernia. There is also the possiblity of strangulation which leads to ischaemic bowel. These situations would require surgery.
What surgery is the patient like to have had in the past ?
The position of the hernia suggests it is an incisional hernia. The patient had an appendicectomy a number of years ago.
Annotate the images :
show the hernia
enlarge the view of the hernia
show the dilated small bowel
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