Narrative Case Report of Postherpetic Pseudoabdominal Hernia

Herpes zoster pseudoabdominal hernia (HZV-PAH) is a rare and easily misdiagnosed complication after varicella-zoster virus (VZV) infection, which is essentially a neurogenic muscle dysfunction rather than a true hernia.

HZV-PAH refers to the dysfunction of nerves innervating abdominal wall muscles (especially the transversus abdominis and internal oblique muscles) caused by VZV invasion of intercostal or lumbar nerves, leading to local muscle relaxation, paralysis, or bulging, resulting in local bulging of the abdominal wall. This disease is relatively rare, with fewer than 2% of cases of abdominal pseudo-hernia reported after herpes zoster infection, mostly occurring in elderly patients with herpes zoster, those with impaired immunity, or those with extensive involvement of dermatomes.

HZV-PAH is a neurogenic muscle disease without anatomical defects of the abdominal wall. Clinicians should improve their awareness of early identification and differential diagnosis to avoid misdiagnosis and unnecessary surgical treatment.