Scan a hernia

Dr.Lloyd Gordon discusses two cases of umbilical lumps that were easily sorted out with POCUS:

This patient had a history of a umbilical hernia which had become larger and painful for a few hours. The patient’s habitus made a manual exam difficult. POCUS showed that there was some small bowel at the tender area which wouldn’t compress and wouldn’t move with pressure and with no peristalsis. The usual CT revealed a hernia but no incarceration, not surprising because her pain was almost gone by then. A hernia repair was done the same day.

This patient had an umbilical hernia repair the week before. Her umbilicus was sort of painful. It looked somewhat painful. Sure enough POCUS showed an abscess.

Editor’s note:  Not only is it relatively easy to determine if a potential hernia has small bowel contents but POCUS helps tell you if your reduction is going well.  I have observed some where the neck of the hernia is tiny and the bowel oedematous and unlikely to squeeze back through which helped in getting an urgent surgical opinion.