Femoral pseudo-hernias

Groin abscess, a rare complication of strangulated femoral hernia: Case report

Femoral hernias account for 8%–11% of all groin hernias and 3%–5% of all anterior abdominal wall hernias. While groin hernias are more common in males, femoral hernias are developed more commonly in female, accounting for 22%–34% of all groin hernias compared with 1.1% in male. The lifetime risk of developing groin hernia in male is approximately 25% but in female less than 5%, so in all female patients with groin hernias, femoral hernias should be included in the differential diagnosis until proven otherwise. The main concern of a femoral hernia is the higher risk of bowel strangulation, presenting emergently in 32%–39% of patients. We report a case of strangulated femoral hernia in a 78-year-old female who was presented to emergency department with groin abscess based on ultrasound image; patient was then diagnosed as having strangulated femoral hernia and taken to the operating theater, where she was found having strangulated segment of small intestine, so the patient underwent bowel resection and anastomosis with repair of the defect extraperitoneally, and ultimately, the patient improved and discharged from the hospital. Strangulated femoral hernia can present with groin abscess. Furthermore, femoral hernia should be ruled out in elderly patient presented with groin abscess, especially female patients.

Indirect inguinal hernia sac containing testis and spermatic cord in an adult patient with cryptorchidism

Sliding hernias are those in which part of the sac wall is formed by a retroperitoneal organ and/or its mesentery protruding outside the abdominal wall cavity. The hernia sac may contain jejunum, ileum, vermiform appendix, Meckel's diverticulum, stomach, ovary, fallopian tube or urinary bladder. Our report features an adult case with cryptorchidism in which testis and spermatic cord constitute a component of the indirect inguinal hernia sac.

MDCT of acute cecal conditions

The cecum comprises a relatively short segment of the gastrointestinal tract, but it can be affected by numerous acute conditions. Acute conditions may arise from processes primary to the cecum, such as volvulus, bascule, neoplasm, and trauma. Alternatively, acute conditions can be due to secondary to systemic or nearby pathology, such as infection, inflammatory processes, ischemia, and infarction. While it is common to suspect appendicitis as the etiology of acute right lower quadrant abdominal pain, the cecum should also be considered as a potential cause of pain, especially in the setting of an abnormal or absent appendix. Multi-detector computed tomography (MDCT) has evolved to become the best imaging modality to evaluate patients presenting with right lower quadrant abdominal pain or suspected acute cecal pathology. Strengths of MDCT include rapid acquisition of images, high spatial resolution, and ability to create multi-planar reconstructed images. In this pictorial review, we illustrate and describe key MDCT findings for various acute cecal conditions with which the emergency radiologist should be familiar.