Challenging hernias: a case series of atypical hernias and review of literature

Authors

  • P. S. Shanthi Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • Vikas C. Kawarat Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India
  • Adithi Shankar Department of General Surgery, Madras Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20230976

Keywords:

Atypical, Traumatic, Lumbar, Interparietal, Flank, Mesh

Abstract

Atypical hernias encompass the categories of flank, lumbar, spigelian, suprapubic and subxiphoid hernias among other rarer variants. These are considered to be tribulation in terms of their diagnosis and management, in that they are in proximity to the bone, which makes defect delineation, adequate mesh overlap, and fixation very challenging. Here, we would like to highlight a selection of our institutional experience with such hernias and their management. Within the institution, 6 cases of such rare hernias repaired within the last 6 months were chosen that posed a therapeutic challenge to the operating team. The cases described are- an interparietal port site incisional hernia, true lumbar hernia, flank region incisional hernia, a traumatic flank hernia, traumatic obstructed interparietal flank hernia, and a traumatic diaphragmatic hernia. All of the above cases were successfully managed by our team by a combination of abdominal wall reconstruction and mesh repair and have not reported any post-operative complications in the follow up period. Literature regarding rare hernia repairs is becoming more exhaustive by the day. However, the likelihood that we encounter such cases in practice is still less. Hence, it is essential to further the knowledge about management of such complex hernias and make an informed decision tailored to the patient’s requirements.

References

Jain R, Venkatesh K. Management of various rare and atypical hernias: experience at a tertiary care centre in central India. Int Surg J. 2016;3:146-52.

Pulle MV, Siddhartha R, Dey A, Mittal T, Malik VK. Port site hernia in laparoscopic surgery: Mechanism, prevention and management. Curr Med Res Pract. 2015;5(3):130-7.

Noorshafiee S, Maddah G, Naghavi Riyabi F, Abdollahi M, Abdollahi A. Port Site Interparietal Hernia After Laparoscopic Splenectomy: A Case Report. ABS. 2004;3(1):100-10.

Kalmar CL, Bower CE. Laparoscopic repair of interparietal abdominal wall hernias. J Surg Case Rep. 2019;2019(11):rjz319.

Heo TG. Primary Grynfeltt's hernia combined with intermuscular lipoma: A case report. Int J Surg Case Rep. 2021;84:106163.

Deshpande A, Deshpande P, Sharma S. Repair of lumbar incisional hernia using polypropylene mesh strip sutures - A case report. Int J Surg Case Rep. 2021;82:105892.

Tianyi FL, Agbor VN, Njim T. Motorbike-handlebar hernia - a rare traumatic abdominal wall hernia: a case report and review of the literature. J Med Case Rep. 2017;11(1):87.

Chow KL, Omi EC, Santaniello J, Lee JK, McElmeel DP, Thomas YM, et al. Traumatic abdominal wall hernias: a single-center case series of surgical management. Trauma Surg Acute Care Open. 2020;5(1):e000495.

Baumann DP, Butler CE. Lateral abdominal wall reconstruction. Semin Plast Surg. 2012;26(1):40-8.

Lu J, Wang B, Che X. Delayed traumatic diaphragmatic hernia: A case-series report and literature review. Medicine. 2016;95(32):e4362.

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Published

2023-03-31

Issue

Section

Case Series