Delayed onset post-herpetic pseudohernia: a case report

Authors

  • Munish Sharma Department of General Surgery, Hindu Rao Hospital, New Delhi, India
  • Ajita Kapur Department of Pharmacology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175417

Keywords:

Abdominal wall, Herpes zoster, Post-herpetic, Pseudohernia

Abstract

Post herpetic pseudo hernia is a rare neurological complication of herpes zoster (HZ). It could lead to diagnostic confusion as abdominal wall herniation presents with similar clinical picture. We present a case of post herpetic pseudo hernia initially misdiagnosed by referring general physician as abdominal wall hernia. A 60-year-old man presented with painless swelling in the right flank for 1 week. The bulge was noticed two weeks after appearance of painful rash of HZ. On clinical examination, fading dried brown rashes were observed in right T10-11 dermatome. No hernial defect was palpable. The bulge became more prominent on standing and coughing. Abdominal sonography report was normal with absence of abdominal mass or hernial defect. The patient was diagnosed as a case of post herpetic pseudo hernia. The bulge resolved spontaneously in 3 months. Physicians should consider the possibility of Post herpetic pseudo hernia if abdominal bulge appears following HZ infection to prevent unnecessary interventions. 

References

Thomas JE, Howard FM. Segmental zoster paresis: a disease profile. Neurol. 1972;22(5):459-66.

Dobrev H, Atanassova P, Sirakov V. Postherpetic abdominal-wall pseudo hernia. Clin Exp Dermatol. 2008;33(5):677-8.

Oliveira PD, Dos Santos Filho PV, de Menezes Ettinger JE, Oliveira IC. Abdominal-wall post herpetic pseudo hernia. Hernia. 2006;10:364-6.

Chernev L, Dado D. Segmental zoster abdominal paresis (zoster pseudo hernia): a review of the literature. PMR. 2013;5(9):786-90.

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Published

2017-11-25

Issue

Section

Case Reports