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Incarcerated "reverse" incisional hernia

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Developed severe central abdominal pain some weeks following extensive mesh abdominal incisional hernia repair.

Patient Data

Age: 65 years
Gender: Female

Small defect in the junction of the rectus abdominis muscles towards the upper end of the mesh repair allowing abdominal wall fat to hernite into the abdominal cavity, displacing the mesh repair (as indicated by metallic markers) posteriorly. Note the herniated fat is markedly inflammed indicating that it is incarcerated and ischemic.

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