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F. M. Bohan, MD
Olean Medical Group Olean, NY

JAMA. 1978;240(17):1855.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

In reading the CLINICAL NOTE by Berk et al (239:2781, 1978), it seems to me that the most unusual aspect of this case is that the patient spent 13 days in the hospital with an obvious incarcerated hernia before she underwent laparotomy.

In reviewing the history as presented, the patient had a persistently tender incisional mass. The patient had a diagnosis of an incarcerated, incisional hernia, yet laparotomy was not undertaken until her 13th hospital day when generalized peritoneal findings developed. It also appears unusual that while attempts were made to treat the symptoms of her recorded Gram-negative sepsis, no attempt was made to correct the underlying incarceration, which was the apparent source of the sepsis.

The clinical course is, of course, prolonged for a patient with complete strangulation of an intestinal loop. However, the course would not be unusual for a patient with ischemia without necrosis . . . [Full Text PDF of this Article]

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