[Strangulated hernia below the umbilicus containing the liver: a case report]

Herniation of liver segments through defects in the anterior abdominal wall is rare. To our knowledge, only three cases have been described in the literature. This study reports the case of a 84-year-old man presenting to the emergency department with strangulated hernia of the linea alba showing dullness to percussion with protrusion of a sensitive and firm mass. Laboratory test results were normal. Abdominal CT scan showed herniation of liver segment through the linea alba with calculous cholecystitis. The patient underwent retrograde cholecystectomy with subhepatic Redon drain and repair of the herniation by overlapping suture, associated with two subcutaneous vacuum suction Redon drains. The post-operative suite was simple and the patient was discharged on the second post-operative day. Six months after surgery, our patient was healthy. Herniation of liver segments through defects in the anterior abdominal wall is rare. Patients usually show little evidence if clinical signs. Abdominal CT scan is essential to assess the viability of parenchymal liver cells. Patients´ management is studied on a case-by-case basis, it can be surgical or non-surgical. Herniation of liver segments is rare; few cases have been reported in the literature and, in these cases, patients showed little evidence of clinical signs. CT scan is essential to assess the viability of parenchymal liver cells.