Laparoscopic decision-making concerning the repair area for traumatic abdominal wall pseudohernia: A case report

Laparoscopic decision-making may be useful for accurately determining the repair area when treating abdominal wall pseudohernia. A 31-year-old man was admitted with a pelvic ring fracture after a traffic accident and underwent orthopedic surgery. Five months after surgery, the patient developed a lower abdominal protrusion. CT revealed abdominal wall bulging and thinning of the abdominal muscle but no musculofascial defects, suggesting a pseudohernia. We reconstructed the abdominal wall and inserted a mesh. Because there was no musculofascial defect, it was difficult to discern the accurate repair area. We used laparoscopy to determine the repair area, which was recognized thanks to illumination transmitted through the abdominal wall. We were able to determine the appropriate size and placement of the mesh, which enabled us to repair the abdominal pseudohernia.