Ann Ital Chir. 2020 Dec 21;91:S2239253X20034714.
The gold standard treatment for incisional ventral hernia (IVH) is a surgical repair with mesh employment, nevertheless this procedure is burdened by several post-operative complications; among these latter, giant pseudocyst of abdominal wall (GPAW) formation is one of the most rare and its etiopathogenesis remains unclear.
We describe the case report of a 36 years old, diabetic and obese woman, previously underwent to a csection and IVH repair with on-lay mesh placement, presented to our unit with an asymptomatic left iliac fossa swelling. At ultrasound (US) and CT scan examination it appears to be a subcutaneous cyst of the anterior abdominal wall associated with a recurrent IVH. Therefore, she underwent to a surgical procedure in order to accomplish a complete excision of the lesion along with a repair of the incisional IVH, with a sub-lay mesh positioning. The extensive dead space resulting from the procedure was managed with a quilting suture. No recurrence or complications have been detected at 2 years follow up.
GPAWs are a rare clinical entity following IVH repair, which occur commonly in female obese patients treated with on-lay mesh positioning. The only effective and definitive treatment is a complete surgical excision along with a correct management of the dead space resulting from the surgical procedure, in order to reduce the recurrence rate.
Abdominal wall, Incisional hernia, Mesh, Pseudocyst, Surgery.
切口疝（IVH）的金标准治疗方法是采用补片的手术修复，但该手术存在多种术后并发症；其中，腹壁巨大假性囊肿（GPAW）的形成较为罕见，其病因和发病机制尚不清楚。
我们描述了一位 36 岁的糖尿病肥胖女性患者的病例报告，她曾因剖宫产和 IVH 修补术（使用无张力补片）而就诊，现因左侧髂窝无症状性肿胀而就诊于我们的科室。在超声（US）和 CT 扫描检查中，该病变被认为是前腹壁的皮下囊肿，同时伴有复发性 IVH。因此，她接受了手术治疗，以彻底切除病变，并对切口疝进行修补，使用的是皮下补片定位。手术过程中产生的广泛死腔通过缝合固定。在 2 年的随访中，未发现复发或并发症。
GPAW 是 IVH 修补术后一种罕见的临床实体，常发生在接受无张力补片定位治疗的肥胖女性患者中。唯一有效的治疗方法是彻底手术切除，并正确处理手术过程中产生的死腔，以降低复发率。
腹壁；切口疝；补片；假性囊肿；手术。
