,HISTORY:  ,The patient is a 98-year-old female who presents from nursing home extended care facility with an incarcerated umbilical hernia, intractable nausea and vomiting and a bowel obstruction. 
,HISTORY : , The patient is a 98 - year - old female who presents from nursing home extended care facility with an incarcerated umbilical hernia , intractable nausea and vomiting and a bowel obstruction .