Small Bowel Obstruction, Right Inguinal Hernia

This patient has a loop of distal small bowel that has become invaginated in a right inguinal hernia. The loop of bowel is not reducible and the patient underwent reparative surgery.
The loop of bowel within the hernia demonstrates wall enhancement and surrounding fluid. Note the large proximal loops of small bowel. The diameter of these loops measured up to 3.5 cm. There is a short segment of ileum after the obstruction that is decompressed prior to the ileocecal valve. The entire colon is decompressed. It is important to realize that the severity of bowel obstruction is measured by the degree of decompression in the distal loops, not the width of the proximal loops. To diagnose a small bowel obstruction, there should be at least a few loops of bowel with diameter greater than 2.5 cm. The appearance of the scout radiograph prior to CT exam (available in case menu) is diagnostic for a small bowel obstruction.