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Reminder of important clinical lesson
Incarcerated umbilical hernia leading to small bowel ischemia
  1. Nancy Lutwak1,
  2. Curt Dill2
  1. 1Department of Emergency Services, VA New York Harbor Healthcare Center, New York, United States
  2. 2Department of Emergency Medicine, VA New York Harbor Healthcare Center, NYU School of Medicine, New York, United States
  1. Correspondence to Dr Nancy Lutwak, nancy.lutwak{at}


A 59-year-old male with history of hepatitis C, refractory ascites requiring multiple paracentesis and transjugular intrahepatic portosystemic shunt placement presented to the emergency department with 2 days of abdominal pain. Physical examination revealed blood pressure of 104/66 and pulse of 94. The abdomen was remarkable for distention and a tender incarcerated umbilical hernia. The skin overlying the hernia was pale with areas of necrosis. The patient immediately underwent laparotomy which was successful.

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  • Competing interests None.

  • Patient consent Obtained.