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Age: 5 months

Sex: Male

Indication: Spitting up, decreased bowel movements

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Case #3


Findings

  • Gas-containing left inguinal hernia
  • Nonobstructive bowel gas pattern
  • No evidence of free intraperitoneal air
  • No abnormal intraabdominal mass effect or calcification
  • Normal appearance of the chest
  • Mild irregularity of the proximal femoral and humeral metaphyses bilaterally


Diagnosis

  • Inguinal hernia
  • Rickets

Sample Report

Gas-containing left inguinal hernia without evidence of bowel obstruction.

No evidence of free intraperitoneal air.

No abnormal intraabdominal mass effect or calcification.

Normal appearance of the chest.

Mild irregularity of the proximal femoral and humeral metaphyses bilaterally, which could relate to rickets. Consider dedicated wrist radiographs for further evaluation.


Discussion

  • Inguinal hernias are an important cause of bowel obstruction in children, in part because the surgical management is more straightforward than many other causes
  • Always look for gas below the inguinal ligaments, as depicted in the annotated image below


Images

Gas (red arrow) below the level of the left inguinal ligament (red dotted line).

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