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Case 141: Vomiting, constipation and an abdominal lump

This man had noticed that his hernia at the umbilicus had become more prominent over the past 4 days. Now it was painful, tender and not reducing as it usually would when he lay down. He had not used his bowels, nor passed flatus for 48 hrs.



Image provided by: Mr Boon Hong, General Surgeon, The Northern Hospital, Victoria Australia.



His plain abdominal xray:

Image provided by: Mr Boon Hong, General Surgeon, The Northern Hospital, Victoria Australia.

1. What is the diagnosis?

2. What part of the bowel is incarcerated and obstructed by the hernia.?

3. What are the options for treatment?