Strangulated Umbilical Hernia with Abscess Formation || Ultrasound || Doppler || Case 199

Strangulated Umbilical Hernia with Abscess Formation || Ultrasound || Doppler || Case 199
Clinical Features:
A 55 years old male patient came with
- Abdominal distension
- Abdominal pain
- Fever
- Painful umbilical irreducible blackish swelling with ulceration
Ultrasound Features:
- At least two echogenic hepatic space occupying lesions.
- Fluid filled distended small intestinal loops with luminal ‘To & Fro’ flow.
- Huge ascites.
- An irreducible herniated structure at the umbilicus containing thick-walled bowel loop, fat & septate fluid with a thick walled complex area having thick sediments.
Surrounding skin thickening & fat stranding.
- Color Doppler shows a whirlpool/whirling pattern of flow within the obstructed bowel loop & only peripheral flow around the complex area within the hernial sac.
Remember:
The thickened hernial sac containing thick-walled irreducible aperistaltic bowel, thick fat & septate fluid with Whirlpool sign will suggest strangulation.
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