Bowel-GI - Inguinal Hernia With Peristalsis
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33 y/o M p/w LLQ and groin pain since bending and lifting heavy boxes the day before. Clinically appears to have an inguinal hernia. Using the inguinal ligament as a guide, the inguinal canal is found at the midpoint between the ASIS and pubic symphysis, just superior to the ligament. The epigastric vessels mark the deep opening of the canal. This can help determine an indirect from direct inguinal hernia. It is estimated that the sensitivity and specificity of POCUS for inguinal hernia detection are 97% and 87% respectively. PMID: 12831490 This is a transverse cut across the left inguinal canal. As the probe moves downward toward the left scrotum, you can see a small loop of bowel contained within the canal. To confirm this is bowel, peristalsis can be seen with fecal material moving in the lumen. There does not appear to be hyperemia or free fluid indicating incarceration or strangulation. The patient was referred to general surgery for repair. Ronald J. Rivera, PGY3 SUNY Downstate / Kings County Emergency Medicine This is the article I used for the sensitivity and specificity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1964363/