case_images: PMC10880186_01
case_images: Abdominal ultrasound executed in the emergency department showing an herniated loop at umbilical site with no vascular abnormality signals on Doppler at patient presentation.
case_images: fped-12-1334562-g001.jpg
case_images: PMC10880186_01_fped-12-1334562-g001.jpg
case_images: F1
case_images: A complete abdominal ultrasound performed in the emergency department revealed diffuse and marked distention of the intestinal loops, the absence of intestinal effusion or invagination, and the presence of a reducible herniated loop at the umbilical site with no vascular abnormalities on doppler (Figure 1).
case_images: Direct abdominal x-ray performed after clinical worsening suggesting intestinal occlusion with multiple aereal levels and hygro-gas stasis.
case_images: fped-12-1334562-g002.jpg
case_images: PMC10880186_01_fped-12-1334562-g002.jpg
case_images: F2
case_images: A direct abdominal x-ray showed signs of hydro-gas stasis and multiple hydro-aerial levels that were relevant to the ileum when there was no free abdominal air (Figure 2).
case_images: An illustrated image showing intraoperative findings with the gangrenous appendix located in the herniary sac. The skin incision is a semilunar incision (U-shaped) below the umbilical scar but we needed to expand the latter with a median longitudinal cut towards the pelvic bone in order to control the intestinal loops for ischemic areas.
case_images: fped-12-1334562-g003.jpg
case_images: PMC10880186_01_fped-12-1334562-g003.jpg
case_images: F3
case_images: An appendectomy was therefore performed on double tobacco-pouch technique, and the abdominal wall defect was sutured (Figure 3).