Virtual Pediatric Hospital: Paediapaedia: Small Bowel Obstruction (SBO)

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Virtual Pediatric Hospital: Paediapaedia: Small Bowel Obstruction (SBO) Paediapaedia: Gastrointestinal Diseases

Small Bowel Obstruction (SBO) Due to Inguinal Hernia

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Usually asymptomatic until the patient develops bowel incarceration and obstruction. The area then becomes tender and there is vomiting with progressive abdominal distentsion. Eighty percent are diagnosed in the first year. There is an increased incidence in premature infants. This is the most common cause of small bowel obstruction in early infancy in children without prior surgery.

Etiology/Pathophysiology:
Inguinal hernias in children are most frequently indirect. In an indirect inguinal hernia the processus vaginalis remains patent and this allows the herniation of abdominal viscera into the scrotum.

Pathology:
Not applicable

Imaging Findings:
Plain abdominal film shows a low mechanical bowel obstruction. Although an air filled loop of bowel in the inguinal region is diagnostic, it is usually not seen as the incarcerated bowel is usually collapsed. The most reliable plain film sign is an asymmetrical swelling of the affected inguinoscrotal fold

DDX:

Not applicable

References:
See References Chapter.

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