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Posterior Rectus Sheath Hernia Causing Chronic Abdominal Pain.

Emily Hammond¹, Caitlin Jones-Sayyid¹, Jason Langer²

¹Augusta University, Department of Surgery, Medical College of Georgia, Augusta, GA, USA.

The American Surgeon

|May 4, 2023

Summary

This summary is machine-generated.

Posterior rectus sheath hernias are rare and challenging to diagnose. This case highlights their potential misdiagnosis and suggests considering them for unexplained chronic abdominal pain.

Keywords:

general surgery hernia

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Area of Science:

Abdominal Surgery
Diagnostic Imaging
Hernia Research

Background:

Posterior rectus sheath hernias are uncommon abdominal wall defects.
Diagnosis can be difficult due to subtle imaging findings and unreliable physical examination.
Chronic abdominal pain without clear etiology necessitates a broad differential diagnosis.

Observation:

An elderly female presented with chronic abdominal pain, initially suspected appendicitis.
CT revealed possible appendicitis and abdominal wall laxity.
A 4 cm hernia defect was identified intraoperatively in the right lateral abdominal wall during laparoscopy.

Findings:

The hernia was diagnosed as a posterior rectus sheath hernia.
The defect was likely iatrogenic, resulting from prior laparoscopic trocar placement.
Appendectomy and mesh herniorrhaphy were successfully performed.

Implications:

This case adds to the limited literature on posterior rectus sheath hernias.
Highlights the importance of considering posterior rectus sheath hernias in patients with unexplained chronic abdominal pain.
Suggests potential iatrogenic causes, such as trocar placement, for these rare hernias.