DYNAMIC EMERGENCY MEDICINE
Ultrasonographic Diagnosis and Facilitated Reduction of an Abdominal Wall Hernia
Article first published online: 19 MAY 2008
© 2008 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 15, Issue 7, pages 691–692, July 2008
How to Cite
Mariani, P. J. (2008), Ultrasonographic Diagnosis and Facilitated Reduction of an Abdominal Wall Hernia. Academic Emergency Medicine, 15: 691–692. doi: 10.1111/j.1553-2712.2008.00138.x
- Issue published online: 10 JUL 2008
- Article first published online: 19 MAY 2008
A 44-year-old man presented to the emergency department with sudden sharp severe periumbilical pain and “bulging” that occurred on a cough while riding in an automobile. Physical exam revealed a firm tender ovoid 4-cm mass just inferolaterally to the left of the umbilicus. Bedside ultrasound with 7.5-MHz linear probe and power Doppler confirmed diagnostic suspicion of abdominal wall hernia without strangulation (Figures 1 and 2). Following intravenous morphine and application of a cold pack to the abdominal mass, closed manual reduction was undertaken with pressure applied via both fingers and transducer under real-time video (available as an online Data Supplement at http://www.blackwell-synergy.com/doi/suppl/10.1111/j.1553-2712.2008.00138.x/suppl_file/acem_138_sm_VideoClipS1.mpg). Almost immediately, the mass was felt and seen to reduce back into the peritoneal cavity. A residual small abdominal wall defect was evident (Figure 3). After a period of observation, during which he remained asymptomatic and stable, the patient was discharged home with a surgical referral.
Video Clip S1. Closed manual reduction undertaken with pressure applied via both fingers and transducer under real-time video. Video clip is in MPEG
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