Huge incisional hernia: A case report

Abstract

Introduction: The incidence of incisional hernia depends on many factors factors including old age, sex, obesity, bowel surgery, suture type, chest infection, abdominal distension and wound infection.

Case report: A 55 years old woman presented at out institute, she had an operation 19 years ago - elsewhere - to remove a branched stone from her right kidney and admitted for two months into the hospital at this time as she had troubles with her surgical wound and she had repeated secondary sutures. The hernia is in the right lumbar region, has a smooth surface, shows expansile impulse on coughing, there are some dilated veins on its surface, there is no tenderness, it has a uniform consistency, mobile, there are no pulsations, it contains large and small intestine, partially reducible, the defect is about 10 cm in diameter and there are no complications. This woman had left nephrectomy two years ago as a treatment for painful non functioning kidney and she is living now with only functioning right kidney with serum creatinine 1.1 mg % and blood urea 38 mg %.

Conclusion: Incisional hernia is a very common complication of wound healing after surgery. Good care and precautions are very important to avoid its development.

Figure 1

The patient at the time of presentation.

Figure 2

The hernia in the standing position.

Figure 3

The hernia in the supine position.