1. MedPix Medical Image Database COW - Case of the Week Case Contributor: Julie A Krumreich Affiliation: Naval Medical Center Portsmouth

2. MedPix No: 8543 - History Pt Demographics: Age = 55 y.o. Gender = man 55 year old male with increasingly sever abdominal pain and constipation times 1 week. Downloaded by (-1)

3. MedPix No: 8543 - EXAM & LABS WBC 10,600ESR 30Distended abdomen, diffusely tender to palpation with enlarged left scrotum demonstrating bowel sounds and peristaltic motion.

4. Sigmoid Colon Inguinal Hernia Select CT image through the lower pelvis demonstrating sigmoid colon herniating into the left scrotum via the inguinal canal. Downloaded by (-1)

5. Sigmoid Colon Inguinal Hernia Causing Bowel Obstruction Select CT image through the abdomen demonstrating dilated bowel loops proximal to the hernia. Downloaded by (-1)

6. Sigmoid Colon Inguinal Hernia Causing Bowel Obstruction Select CT image through the abdomen demonstrating sigmoid colon entering the inguinal canal Downloaded by (-1)

7. FINDINGS Left inguinal hernia containing nonincarcerated sigmoid colon causing a large bowel obstruction.

8. DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis?

9. Diagnosis: Colonic Inguinal Hernia Dx Confirmed by: Surgical Reduction

10. DISCUSSION