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Myonecrosis of the rectus muscle after a Cherney incision
A M Ries1, L R Nycum, M E Reed
1Division of Gynecologic Oncology, Walter Reed Army Medical Center, Washington, DC 20892, USA.
Background:
The original description of the Cherney incision includes bilateral ligation of the inferior epigastric vessels to increase incision width [1]. However, in patients with compromised abdominal wall vasculature, ligation may lead to healing complications.
Case:
Our patient experienced necrosis of the right rectus muscle after undergoing pelvic surgery via a Cherney incision. During the procedure, attempts were made to retain both inferior epigastric arteries, but the right was transected and ligated. Sepsis developed and myofascitis was diagnosed. The interesting radiographic findings of myofascitis are also presented.
Conclusion:
The vasculature of our patient's abdominal wall may have been compromised after four previous transverse abdominal incisions, and the ligation of the right inferior epigastric vessel may have contributed to postoperative complications.