Primary Ventral Hernia as an Uncommon Cause of Small Bowel Obstruction in a Surgically Naïve Patient: A Clinical Case Report

Small bowel obstruction (SBO) is a common surgical emergency with multiple etiologies, including adhesions, malignancy, and hernias. In patients with no prior abdominal surgery, incarcerated hernias are an uncommon but important cause of mechanical obstruction. We report the case of a 44-year-old African-American woman with no surgical history who presented with progressive abdominal pain, bilious vomiting, and a nonreducible ventral abdominal wall mass. Prompt surgical exploration revealed a 4-cm incarcerated ventral hernia with compromised omentum. Early recognition and timely operative intervention prevented bowel ischemia and resulted in an uncomplicated recovery. This case highlights the importance of considering ventral hernia as a cause of SBO in patients with a surgically naïve abdomen and reinforces the need for rapid operative management to prevent serious complications.