Background: A hernia is an aponeurotic defect that allows an organ to protrude from its normal cavity. Despite advancements in hernia care, hernia patients' experiences with care, as well as recurrence and complication rates, are frequently suboptimal. Adequate knowledge of the risk factors of a hernia could lead to a significant reduction in the prevalence of hernia. Therefore, the current study aimed to assess the awareness of the risk factors of abdominal hernias among adults in Saudi Arabia. Methodology: Our study is a cross-sectional analytic study to measure the level of knowledge, awareness, and practice of ventral and inguinal hernias in Saudi Arabia. The data was collected by using a valid pretested structured questionnaire taken from previous studies after getting writing approval. Results: In this study, we were able to collect data from 2611 individuals in different regions of Saudi Arabia, where 68.5% of the participants were females and 60.1% were aged between 18-29 years old. The prevalence of hernia among individuals in the current study was 9.2%, associated with participants older than 40 years old (19.1%), participants of the northern region (16.6%), illiterate individuals (30.0%), married (13.2%), and overweight or obese individuals (10.9% and 12.6%). In general, 53.7 % of the participants had a moderate level of knowledge, while 23.8% had a high level and 22.5% had a low level of knowledge. Conclusion: We found a moderate level of knowledge among adult individuals in Saudi Arabia about hernia. The prevalence of hernia was similar to those reported in previous studies; however, there is a higher incidence of risk factors in the current population.

Background and Clinical Significance: Gallstone ileus (GI) is a rare but serious complication of gallstone disease. This condition is characterized by migration of gallstones through a cholecystoenteric fistula, resulting in mechanical bowel obstruction. GI primarily affects older patients with multiple comorbidities. Case Presentation: Herein, we describe a case of 68-year-old Saudi woman with a history of end-stage renal disease, pulmonary hypertension, diabetes mellitus, bronchial asthma, and atrial fibrillation. She presented with acute calculous cholecystitis. Due to her condition, she was managed conservatively initially. The patient was recommended laparoscopic cholecystectomy but she declined due to fear of anesthesia-related complications. She re-presented after two months with abdominal pain, vomiting, distension, and constipation. Computed tomography (CT) scan showed a 3.2 cm ectopic gallstone impacted in the distal ileum with proximal bowel dilatation and segmental ischemia, confirming GI. Laparotomy showed bowel ischemia and localized perforation. The patient was managed with enterolithotomy, resection of 25 cm of distal ileum, and primary anastomosis. Post-surgery, the patient had favorable recovery. Conclusions: This case highlights need for early diagnosis and appropriate management of GI in patients with multiple comorbidities.