Garrett Celine, Wijayawardana Ruwanthi, Morris David L
Liver and Peritonectomy Unit, St George Hospital, Kogarah, NSW, Australia.
Faculty of Medicine & Health, St George and Sutherland Clinical School (University of New South Wales), Clinical Sciences (WRPitney) Building, St George Hospital, Kogarah, NSW, Australia, 2217.
J Surg Case Rep. 2023 Apr 12;2023(4):rjad175. doi: 10.1093/jscr/rjad175. eCollection 2023 Apr.
Interparietal hernias are rare and occur most commonly in the long-term postoperative setting following abdominopelvic surgery. This case report describes the development of a strangulated interparietal hernia through a defect in the posterior rectus sheath 4 days post-lower segment caesarean section (LSCS) in a 36-year-old female. Whilst she had an acute abdomen, she did not have a palpable incisional hernia. Her interparietal hernia was identified via a computed tomography scan of her abdomen and pelvis. She underwent a midline laparotomy where ischaemic small bowel was found within her hernia. This was resected and she had an unremarkable recovery. This case is the first of its kind and highlights the diagnostic challenge of interparietal hernias in acute postoperative patients as well as the importance of having a low threshold for suspicion for complicated interparietal hernias in patients with an acute abdomen following LSCS.
腹直肌间疝较为罕见，最常见于腹盆腔手术后的长期术后阶段。本病例报告描述了一名36岁女性在低位剖宫产术后4天，通过腹直肌后鞘缺损发生绞窄性腹直肌间疝的情况。虽然她有急腹症，但未触及切口疝。通过腹部和盆腔计算机断层扫描确定了她的腹直肌间疝。她接受了中线剖腹手术，发现疝内有缺血性小肠。小肠被切除，她恢复良好。本病例尚属首例，突出了急性术后患者腹直肌间疝的诊断挑战，以及对于低位剖宫产术后急腹症患者，对复杂腹直肌间疝保持低怀疑阈值的重要性。
