ABSTRACT
This chapter presents a case study of a 75-year-old lady who is presented with a 6-hour history of severe, gripping abdominal pain that peaks in waves. This patient has small bowel obstruction (SBO), secondary to an incarcerated femoral hernia. The typical symptoms and signs of SBO are severe central cramping/griping abdominal pain, nausea and vomiting and high-pitched bowel sounds. Examination should include inspection for post-operative scars as well as all the hernia orifices. Typically, an incarcerated hernia cannot be reduced, has tense contents and has normal overlying skin. Management includes nasogastric aspiration with free drainage to reduce distention and the risk of aspiration. Dehydration and electrolyte imbalances should be corrected with appropriate intravenous fluids and regular fluid input/output monitoring. If the cause of SBO is adhesion, a 'drip and suck' conservative approach can be trialed for 24 hours. Indications for surgery are worsening abdominal pain, sepsis or peritonism.
