Presentation
Abdominal pain, nausea, vomiting.
Patient Data
Bilateral lower lobe acute pulmonary emboli with small left effusion and hemorrhage. Diffuse dilation of small bowel with transition point at the right paramidline verntral hernia defect in the lower abdomen just above the umbilicus, which contains a single incarcerated loop. Distal small bowel is decompressed. Small ascites.
Case Discussion
Incarcerated loop of small bowel in a ventral hernia resulting in small bowel obstruction. This type of finding can sometimes be successfully reduced manually without need for surgery. Be sure to carefully evaluate the lower chest on your abdominal CT scans, as you may occasionally (as in this case) detect pulmonary emboli.