Atri Souhaib, Hammami Mahdi, Ben Mahmoud Ahmed, Sebai Amine, Maghrebi Houcine, Kacem Montassar
Department of General Surgery, Hospital la Rabta, Tunis, Tunisia.
Department of General Surgery, Hospital la Rabta, Tunis, Tunisia.
Int J Surg Case Rep. 2024 Jan;114:109191. doi: 10.1016/j.ijscr.2023.109191. Epub 2023 Dec 24.
Herpes zoster (HZ), caused by the reactivation of the Varicella-Zoster virus, is typically characterized by sensory complications. However, motor complications, such as abdominal pseudohernia, are rare and exceptional. This report presents a case of post-herpes zoster pseudo-hernia in a previously healthy 54-year-old man.
A 54-year-old Caucasian patient developed an abdominal wall protrusion over two weeks, following a resolved herpes zoster infection. Physical examination revealed healed skin lesions and a painless protrusion on the right flank, triggered by coughing, suggesting an abdominal wall hernia. Abdominal CT scan ruled out parietal but noted asymmetry in the abdominal wall muscles, particularly thinning on the right side. The diagnosis of post-herpes zoster pseudo-hernia was established, with spontaneous resolution occurring after four months.
Herpes zoster typically manifests as a sensory condition. However, motor complications can lead to muscle weakness or paralysis. Pseudo-herniation is a rare motor complication, affecting less than 1 % of cases. It must be differentiated from true abdominal wall hernias, which require surgical intervention. Pseudo-hernia typically presents as painless abdominal bulging, often asymptomatic, but can lead to gastrointestinal issues if visceral nerves are affected. Imaging studies and EMG may be employed for diagnosis. Treatment for pseudo-hernia is conservative, addressing the underlying HZ, and the prognosis is favorable, with most cases resolving within 3 to 12 months.
Abdominal post-herpes zoster pseudo-hernia is a rare HZ complication. Recognizing this entity is crucial, as it typically resolves spontaneously without surgical intervention. This case aims to enhance awareness of this exceptional clinical manifestation.
带状疱疹（HZ）由水痘-带状疱疹病毒再激活引起，通常以感觉并发症为特征。然而，运动并发症，如腹部假性疝，却罕见且特殊。本报告介绍了一例54岁既往健康男性的带状疱疹后假性疝病例。
一名54岁的白种人患者在带状疱疹感染痊愈后两周出现腹壁突出。体格检查发现皮肤病变已愈合，右侧胁腹有一无痛性突出物，咳嗽时出现，提示腹壁疝。腹部CT扫描排除了壁层病变，但发现腹壁肌肉不对称，尤其是右侧变薄。确诊为带状疱疹后假性疝，四个月后自行缓解。
带状疱疹通常表现为感觉障碍。然而，运动并发症可导致肌肉无力或麻痹。假性疝是一种罕见的运动并发症，发生率不到1%。必须将其与真正的腹壁疝相鉴别，后者需要手术干预。假性疝通常表现为无痛性腹部隆起，常无症状，但如果内脏神经受影响，可能会导致胃肠道问题。影像学检查和肌电图可用于诊断。假性疝的治疗是保守的，针对潜在的带状疱疹，预后良好，大多数病例在3至12个月内缓解。
腹部带状疱疹后假性疝是一种罕见的带状疱疹并发症。认识到这一实体至关重要，因为它通常无需手术干预即可自行缓解。本病例旨在提高对这种特殊临床表现的认识。
