Giant incisional hernia
Keywords:
SURGICAL PROCEDURES, OPERATIVE, INCISIONAL HERNIA, INTRAOPERATIVE COMPLICATIONSAbstract
Incisional hernia is a defect of the abdominal wall, with or without volume increase, in the area of a postoperative scar, which is perceptible or palpable on clinical or imaging examination. It is a failure of wall reconstruction during an abdominal surgery, constituting a challenge for surgeons. We present the case of a 59-year-old mixed-race female worker with a history of hypertension, diabetes mellitus and obesity. She had undergone several laparotomies due to gallstones, acute appendicitis and uterine fibroma. She also suffered a grade III burn with more than 50 % involvement of the body surface. She presented to the surgery emergency department with manifestations of pseudo or partial occlusion, abdominal cramps, distention, flatulence and a lot of pain. She was admitted for the surgical study and treatment of a large incisional hernia. Diet is ordered, as well as the use of a large abdominal truss that was adjusted every three days. In addition, basic treatment was carried out for arterial hypertension and diabetes mellitus. At 15 days of admission, it was decided to schedule surgery and operate her on using combined facial techniques. The entire hernial sac was resected, the peritoneum was closed and flaps were made with her own tissues, making it possible to achieve the closure of the abdominal wall completely, without the use of prosthetic material. Pneumoperitoneum surgery was not performed to reduce the hernial content to the cavity. The patient progressed satisfactorily.Downloads
References
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