Abdominal Bulging Due to Abdominal Muscle Palsy Secondary to Herpes Zoster: A Report of a Rare Case

Abstract

A 59-year-old man visited our hospital for examination of left-sided abdominal bulging. About a week earlier, he had developed an abdominal skin rash and was diagnosed with herpes zoster. Computed tomography excluded intra-abdominal organic disease and true hernia. We diagnosed the patient with abdominal muscle palsy, i.e., abdominal pseudohernia, secondary to varicella zoster reactivation. Abdominal pseudohernia is a rare complication of herpes zoster but is not life-threatening. Nevertheless, physicians should keep this clinical entity in mind when examining a patient presenting with abdominal wall bulging.

Keywords: abdominal bulging; abdominal muscle palsy; abdominal pseudohernia; herpes zoster; varicella zoster virus.

Figure 1. Photographs. (a) At the first hospital visit, a red rash is observed at the lower left side of the navel, near the abdominal bulge. (b) Three months later, the abdominal bulging persists.

Figure 2. (a) Plain abdominal X-ray: The profile of the left-sided abdominal wall bulging is evident (arrows), but no detailed structure is visible. (b) Abdominal computed tomography without contrast (horizontal section): Thinning of the left-sided abdominal muscles is seen (arrows), but there is no lesion in the intra-abdominal space.