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ABDOMINAL AORTIC ANEURYSM, INGUINAL HERNIAS AND EMPHYSEMA

[Extract] We recently referred a 79-year-old man with a history of emphysema, who presented with small bowel obstruction. Examination of the abdomen showed a large abdominal aortic aneurysm (AAA) and enormous bilateral nonreducible inguinal hernias. Obstructive bowel sounds were audible over both hernias, and the right one was tender. Abdominal computed tomography showed a 10-cm suprarenal AAA (Fig. 1, arrow) and dilated stomach and small bowel. The right inguinal hernia contained caecum and dilated and normal small bowel (Fig. 2, arrow), suggesting this is a sight of obstruction.