Mommy my Tummy Hurts
A 2-month-old boy was brought into emergency because of continuous vomiting, crying and what appeared to be a swollen abdomen. The baby was born at 36 weeks gestation but had no medical history. The mother had fed the infant earlier that morning and the baby vomited about an hour later; the vomit was a greenish colour. The baby has been crying and uncomfortable all morning. Physical examination revealed an extended abdomen, loud high-pitched bowl sounds indicating gurgling of gas and fluid in the bowel. A swelling was also noted around the left inguinal region and tenderness of the left testis. The boy's body temperature is slightly elevated. The infant was diagnosed with an indirect inguinal hernia.
Clinicoanatomical considerations:
1. What is an indirect hernia?
2. Why would this occur in an infant?
3. What anatomical relationships would explain the distended abdomen and vomiting in this condition?
4. What would cause the vomit to be green?
5. Comment on the sounds that were heard on physical examination and the seriousness of this condition.