Worsening Abdominal Pain in Surgery — 90yo Woman | General Surgery | SMLE Q#777
SMLE Question #777
Surgery
General Surgery
Last updated: February 2026
A 90-year-old woman with a long-standing incisional hernia presents with worsening abdominal pain and feculent discharge from an ulcerated area over the hernia. Examination shows a large, irreducible, tender incisional hernia with overlying skin ulceration and necrotic patches; bowel loops are palpable within the sac. There is no generalized peritonitis. What is the most appropriate next step in management?
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