Gastric outlet obstruction secondary to paraumbilical hernia

Abstract

An 80-year-old woman with a history of paraumbilical hernia presented with a 5-day history of abdominal pain, nausea, and vomiting. She reported a dull pressure that progressively increased in her abdomen with post-prandial vomiting. On examination, there was a large non-tender reducible supra-umbilical hernia with no overlying erythema. Blood examination revealed a white cell count of 15.96 × 109/L, C-reactive protein of 29 mg/L, and venous lactate of 3.0 mmol/L. Computed tomography (CT) of the abdomen and pelvis revealed a large paraumbilical hernia containing the distal stomach and loops of small and large bowel (Fig 1).