50 year old gentleman with a 2 year history of inguinoscrotal swelling presented with acute severe pain at the site of swelling since one day.
Indirect left inguinal hernia with an afferent and efferent loop of distal descending colon / proximal sigmoid colon as content with associated sigmoid mesentery. mild peribowel free fluid. No features of bowel wall thickening or pneumatosis. Scrotal contents are displaced inferiorly.
Following small bowel, the next common structure to herniate into the inguinal canal is the large bowel. The gaseous nature of large bowel makes ultrasound of limited value in evaluating the content of the hernial sac. CT correlation done in this patient helped identify the loop of interest and also the extent of it’s affliction.
- Radiopaedia – indirect inguinal hernia
- Burkhardt, Joan Hu, et al. “Diagnosis of inguinal region hernias with axial CT: the lateral crescent sign and other key findings.” Radiographics 31.2 (2011): E1-E12.