554 An Unusual Case of a “Hernia Within a Hernia” Resulting in Small Bowel Obstruction and Strangulation

Abstract 59-year-old female presented with symptoms of small bowel obstruction. She had a history previous open right hemi-colectomy. also complex strangulated ventral hernia which required laparotomy and repair. Following this the patient recurrence hernia. Examination demonstrated non-tender irreducible recurrent in high BMI (> 40). CT reported midline containing dilated loops. Additionally, there was separate narrower arising from original larger loop bowel. Emergency performed. At operation large smaller secondary hernial defect. Within defect, jejunum constriction band. released. There no vascular compromise to need for resection. The sac excised abdominal wall repaired. Post-operative recovery uneventful. Discussion known, wide necked However, first presentation new, This case is unusual that it demonstrates multi-locular “hernia within hernia”. Although hernias have been previously described, paucity literature on these. Conclusions hernia” an uncommon surgical finding limited literature. Clearly without urgent intervention would be increase morbidity mortality.