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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