Atypical abdominal hernias in the emergency department: acute and non-acute

The objective of this pictorial essay is to review uncommon abdominal hernias, many of which present to the Emergency Department with abdominal pain. These hernias may be congenital, post-traumatic, or iatrogenic in origin. They may present as an acute (surgical) abdomen without localizing signs or symptoms. They may present with an obvious antecedent event such as motor vehicle trauma or simply present as an incidental finding. Multi-detector computed tomography is currently the study of choice to diagnose abdominal hernia and to evaluate the possible complications such as small bowel obstruction and/or strangulation. This modality can delineate a “zone of transition” (abnormally dilated bowel transitioning to normal or decreased bowel caliber) or identify the involved anatomy. It can also suggest compromised blood supply.