Bilateral non-traumatic multiple calf muscle hernias in a young adult: a rare case report

Muscle hernia refers to the localized protrusion of muscle from a weak point due to fascia defects. Muscle hernias can be classified as structural or traumatic. There are many reasons for the formation of fascia defects. Currently, there are few reports on the causes of muscle hernia in clinical practice. There are not many patients with muscle hernia in clinical practice, and there are fewer patients with multiple muscle hernias. The reasons for their multiple occurrence are worth exploring. Patients usually seek medical advice due to pain, cosmetic reasons or concerns about tumors. This disease is often ignored by doctors, which can easily lead to misdiagnosis and delayed treatment.

We report a rare case of multiple muscle hernias in both lower limbs in a 25-year-old adult. The patient has been exercising a lot for a long time. The muscle hernias were more obvious when running and squatting, but were asymptomatic. We used ultrasonography to examine the muscle hernias one by one and found that most of them had a large number of blood vessels. We diagnosed the patient with multiple muscle hernias in both lower legs. Conservative treatment such as wearing elastic stockings and limiting running activities was performed, and regular outpatient follow-up was performed. When the patient was followed up 3 months later, no significant changes were found in the number and morphology of calf muscle hernias.

We reviewed a large number of literatures and found that few of them reported the relationship between muscle hernia and blood vessels. Most of the muscle hernias in this patient had arteries and veins passing through them, which may be the cause of the weak fascia. In addition, he has been running for a long time and is susceptible to chronic fascial syndrome. His muscle fibers have become larger and he has repeatedly directly damaged the fascia. These combined factors may have led to the formation of multiple muscle hernias in both lower limbs. The formation of multiple muscle hernias in the patient's calves may be related to vascular perforation and excessive exercise. The patient was advised to wear elastic stockings and reduce exercise. During follow-up, no obvious changes were found in his muscle hernias. It is hoped that clinicians can have a better understanding of the diagnosis and treatment of muscle hernias through this case.