1. Man With Sharp Periumbilical Pain
Heather M. Volkamer, MD, Brianne Steele, MD, Joshua Broder, MD 
Annals of Emergency Medicine 
Volume 67, Issue 4, (April 2016)
DOI: /j.annemergmed
Copyright © 2016 American College of Emergency Physicians Terms and Conditions

2. Figure 1
The patient’s protuberant abdomen and an umbilical bulge in the setting of known ascites.
Annals of Emergency Medicine  , DOI: ( /j.annemergmed )
Copyright © 2016 American College of Emergency Physicians Terms and Conditions

3. Figure 2
Transabdominal ultrasonography demonstrating a loop of small bowel (arrowhead) with a narrowed neck (long arrow) projecting superficial to the rectus abdominis muscles (short arrows).
Annals of Emergency Medicine  , DOI: ( /j.annemergmed )
Copyright © 2016 American College of Emergency Physicians Terms and Conditions

4. Figure 3 After reduction, the umbilicus was no longer protuberant.
Annals of Emergency Medicine  , DOI: ( /j.annemergmed )
Copyright © 2016 American College of Emergency Physicians Terms and Conditions

5. Figure 4
Postreduction transabdominal ultrasonography revealing the previously visualized small bowel loop (arrowhead) now deep to the rectus abdominis muscles (short arrows) and a hernia defect (long arrow) separating the rectus abdominis muscles at the linea alba.
Annals of Emergency Medicine  , DOI: ( /j.annemergmed )
Copyright © 2016 American College of Emergency Physicians Terms and Conditions