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