When Abdominal Pain Hides a Surgical Emergency

A 77-year-old woman presents with Abdominal pain, nausea, and vomiting. CT reveals a femoral hernia. Explore the diagnosis and management of this emergency.

Emergent surgical repair


A 77-year-old woman presented to the emergency department with a 2-day history of abdominal pain, nausea, and vomiting. On physical examination, there was abdominal distension with tenderness in the left lower quadrant. Computed tomography of the abdomen showed herniation of a loop of ileum on the left side inferior to the inguinal ligament, lateral to the pubic tubercle, and medial to the common femoral vessels with compression the femoral vein. Small bowel loops were dilated proximal to the herniation and collapsed distal to it. What is the most appropriate management for this patient?

What is the most likely diagnosis?

Bowel regimen
Elective surgical repair
Emergent surgical repair
Manual reduction
Nasogastric tube insertion and nil per os

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