Anterior abdominal wall abscess
Morbidly obese 42 year old female presents to emergency with fevers and sepsis on a background of an incisional hernia repair 1 month ago.
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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.
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.