Anterior abdominal wall abscess

Case contributed by Dr Chad Wong

Presentation

Morbidly obese female presents to emergency with fevers and sepsis on a background of an incisional hernia repair 1 month ago.

Patient Data

Age: 40 years
Gender: Female

Incomplete imaging of anterior and left side of abdomen due to body habitus.

There is a large anterior abdominal wall hernia measuring 9.5cm minimum in diameter. This contains non-dilated small and large bowel. Within the subcutaneous fat anterior to the hernia there is a 17.7 x 7.3 cm fluid collection. There are some flecks of gas and some peripheral enhancement suggesting abscess.

Case Discussion

The patient was taken to theater and a washout showed a colonic fistula post incisional hernia repair (1 month ago) and feculent fluid. Suspected infected mesh leading to a large abscess in anterior abdominal wall.

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