scholarly journals An unusual presentation and management of incarcerated Richter’s type of Spigelian hernia: a rare case report and review of literature

2020 ◽  
Vol 7 (11) ◽  
pp. 3856
Author(s):  
Prabhu Ravi ◽  
Ramprasad Rajebhosale ◽  
Najam Husain
Keyword(s):  
Abdominal Wall ◽  
Iliac Fossa ◽  
Abdominal Wall Hernia ◽  
Abdominal Distension ◽  
Sudden Onset ◽  
Review Of Literature ◽  
Lower Abdomen ◽  
Lateral Abdominal Wall ◽  
Rare Case Report ◽  
Semilunar Line

Spigelian hernias (SH) are one of the rare forms of ventral abdominal hernias which constitutes about 1-2%. SH occurs through the defect in the anterior abdominal wall adjacent to the semilunar line which occurs in the lower abdomen where the posterior sheath is deficient. The usual presentation of SH is a painful mass in mid abdomen above anterior superior iliac spine (ASIS). The diagnosis is made by means of ultrasound and computed tomography (CT). We report 69 years old female who is a known case of Parkinson’s disease and on medication presented with 2 days of sudden-onset right iliac fossa (RIF) associated with intermittent nausea, vomiting and also abdominal distension. O/E: Abdomen soft, tenderness in RIF with swelling above the line of ASIS. With the diagnosis of lateral abdominal wall hernia we took a CT scan that shows obstructed SH. Immediately she underwent surgery, intra-operative picture shows intraparietal hernia with Richter’s type and viable bowel. Abdominal wall is very weak and flimsy with no proper differentiation between the layers. Preperitoneal mesh repair was performed. The post-operative (post op) period was uneventful. Till now there was only 6 type of Richter’s SH reported. In this article we discuss a brief knowledge of SH and the management part of SH. We hope that this article will benefit among the surgeons in treating with SH. 

scholarly journals Parasitic Myoma: A Very Rare Case Report aAnd Review of Literature

2019 ◽  
Vol 17 (1) ◽  
pp. 50-53
Author(s):  
Md Manir Hossain Khan ◽  
Jobaida Sultana
Keyword(s):  
Abdominal Wall ◽  
Blood Supply ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Low Grade ◽  
Review Of Literature ◽  
Rare Case Report ◽  
History Of ◽  
The Right ◽  
Further Development

A 32 years old unmarried women presented with periumbilical colickey abdominal pain which shiftted to the right iliac fossa with anorexia, vomiting and low grade fever. She had history of open myomectomy 4 years back for menorrhagia with multiple fibroids (myomas). On examination, the pointing sign, Rovsing's sign, McBurney's sign &Blumberg's sign were positive. Then she was diagnosed as a case of acute appendicitis. Ultrasonography revealed nothing significant. Appendicectomy was done through right Grid Iron incision. Appendix was found inflammed, swollen and there was collection of fluid in the peritoneal cavity. During closure, incidentally a solid mass about 5 ><4 ><2.5 cm was found exterior to the peritoneum near the incision at the abdominal wall. The mass was excised. Subsequently histopathotology confirmed a leiomyoma (Myoma or parasitic fibroid). The parasitic myoma may develop spontaneously as pedanculatedsubcerousmyomaloose their uterine blood supply or iatrogenically from retained fragment of myoma from previous myomectomy or hysterectomy and get blood supply from abdominal wall. Even small bits displaced into the abdominal cavity can result in parasitic fibroids. This case is reported here to give emphasis on the surveilence of parasitic myoma during myomectomy or hysterectomy for fibroid uterus and all tissue pieces that are morcellated should be delligently removed for the prevention of further development of parasitic myoma. Journal of Surgical Sciences (2013) Vol. 17 (1) : 50-53

scholarly journals TRAUMATIC ABDOMINAL WALL HERNIA : A RARE CASE REPORT

2015 ◽  
Vol 2 (3) ◽  
pp. 300-303
Author(s):  
Waddi Sudhakar ◽  
Gandeti Kirankumar ◽  
Harshavardan Majety S R ◽  
Abburi Srinivas ◽  
Mula Rohit Babu
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Rare Case ◽  
Abdominal Wall Hernia ◽  
Traumatic Abdominal Wall Hernia ◽  
Rare Case Report

Concomitant Anterior and Posterior Component Separations: Absolutely Contraindicated?

2020 ◽  
pp. 155335062091419
Author(s):  
Jorge Daes ◽  
Joshua S. Winder ◽  
Eric M. Pauli
Keyword(s):  
Abdominal Wall ◽  
Lateral Displacement ◽  
Abdominal Wall Reconstruction ◽  
Component Separation ◽  
Transversus Abdominis ◽  
Lateral Abdominal Wall ◽  
Computed Tomography Images ◽  
Fresh Cadaver ◽  
Semilunar Line ◽  
Internal Oblique

Many experts in abdominal wall reconstruction believe that the combination of simultaneous ipsilateral anterior component separation (ACS) and posterior component separation (PCS) is contraindicated. We performed ipsilateral endoscopic ACS and either endoscopic or open PCS-transversus abdominis release (TAR) in 5 fresh cadaver models. The full length of the semilunar line and the lateral abdominal wall remained well reinforced by 2 complete layers, comprising the internal oblique (IO) and TA muscles and their investing fasciae. Myofascial releases occurred 4 cm (median) apart. Additionally, we reviewed computed tomography images at 1 month and 1 year after PCS-TAR in 17 patients (30 PCS-TARs). Lateral displacement of the TA relative to the rectus abdominis (RA) was significant only at the superior mesenteric artery level, where it was <1 cm (median). Muscle mass changed minimally over time. Several studies showed that abdominal wall reconstruction after PCS-TAR results in compensatory muscular hypertrophy of the RA, external oblique (EO), and IO muscles and provides better quality of life and improved core physiology. These changes did not occur when the midline was not restored. Theoretically, endoscopic ACS-EO may be added to PCS-TAR to avoid partially bridged mesh repair in patients in whom complete midline restoration is impossible via PCS-TAR alone. Nevertheless, we advise most surgeons to perform a small-bridged repair instead of risking increased morbidity by attempting a highly complicated procedure.

A Large Single-Center ‘Experience of Open Lateral Abdominal Wall Hernia Repairs

2016 ◽  
Vol 82 (7) ◽  
pp. 608-612 ◽  
Author(s):  
Puraj P. Patel ◽  
Jeremy A. Warren ◽  
Roozbeh Mansour ◽  
William S. Cobb ◽  
Alfredo M. Carbonell
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Lateral Wall ◽  
Synthetic Mesh ◽  
Mesh Placement ◽  
Lateral Abdominal Wall ◽  
Single Center Experience ◽  
European Hernia Society ◽  
Open Mesh Repair ◽  
Mesh Reconstruction

Lateral abdominal wall hernias may occur after a variety of procedures, including anterior spine exposure, urologic procedures, ostomy closures, or after trauma. Anatomically, these hernias are challenging and require a complete understanding of abdominal wall, interparietal and retroperitoneal, anatomy for successful repair. Mesh placement requires extensive dissection of often unfamiliar planes, and its fixation is difficult. We report our experience with open mesh repair of lateral abdominal wall hernias. A retrospective review of a prospectively maintained database was performed to identify patients with a classification of lateral abdominal wall hernia who underwent an open repair. A total of 61 patients underwent open lateral hernia repairs. Mean patient age was 58 years (range 25–78), with a mean body mass index of 32 kg/m2 (range 19.0–59.1). According to the European Hernia Society classification, defects were located subcostal (L1, 14 patients), flank (L2, 33 patients), iliac (L3, 11 patients), and lumber (L4, 3 patients). Mean defect size was 78.6 cm2, with a mean greatest single dimension of 9.2 cm (range 2–25 cm). Retromuscular or interparietal repair was performed in 50.8 per cent, preperitoneal in 41.0 per cent, intraperitoneal in 6.6 per cent, and onlay in 1.6 per cent. The rate of surgical site occurrence was 49.2 per cent, primarily seroma and surgical site infection rate was 13.1 per cent. With a mean follow-up of 15.4 months, seven patients (11.5%) have documented recurrence. Synthetic mesh reconstruction of lateral wall hernias is challenging. Our experience demonstrates the safety and success of repair using synthetic mesh primarily in the retromuscular, interparietal, or preperitoneal planes.

Non-incisional traumatic lateral abdominal wall hernia

2017 ◽  
Vol 87 (11) ◽  
pp. 952-953
Author(s):  
Vipul D. Yagnik ◽  
Vismit Joshipura
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Lateral Abdominal Wall
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