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Small bowel obstruction due to incarcerated sciatic hernia: ultrasound diagnosis

¹ Department of Radiology, Chang Gung University, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833 and ² Department of Radiology, Chang Gung University, Chang Gung Memorial Hospital at Linkou, 5 Fu-Shing Street, Kwei Shan, Tao Yuan, Taiwan

Correspondence: Sheung-Fat Ko, MD

A 71-year-old woman presented with vomiting, abdominal pain and vague right gluteal discomfort. Abdominal ultrasound showed ascites and dilated small bowel loops with peristaltic movement, while transgluteal ultrasound revealed entrapped ascites beneath gluteal muscles and an oedematous, immobile bowel loop trapped between the sacrum and iliac bone with barely visible colour Doppler flow suggestive of an incarcerated sciatic hernia. CT demonstrated similar findings and subsequent surgery confirmed the diagnosis. To our knowledge, this is the first report of a pre-operative diagnosis of incarcerated sciatic hernia on ultrasound.