Figure it out fridays
A 22 day old male boy presented with febrile occlusion for the past 2 days. He was hemodynamically stable with distended abdomen and right inguino-scrotal swelling (as shown) with negative transillumination test. After primary resuscitation, radiological exams showed a complicated inguinal hernia. Decision to operate was taken and intraoperative findings are shown above. What is the most likely diagnosis?