An incisional bladder hernia following appendectomy: report of a case

Abstract

We herein report the case of a 68-year-old male who presented with a few years' history of swelling at the scar of an appendectomy, which he had undergone nearly 40 years earlier, and which was associated with radiating pain towards the penis when he pushed on the swelling. The scar was located in the right lower quadrant of the abdomen. Abdominal sonography and a computed tomography (CT) scan demonstrated the presence of an incisional bladder hernia, and surgery was performed. The herniated bladder was successfully replaced into the preperitoneal space, and the orifice was covered with a polypropylene mesh. Most bladder hernias develop in the inguinal and/or femoral region, and an incisional bladder hernia is extremely rare, especially after abdominal surgery. To our knowledge, this is the fourth report of an incisional bladder hernia following abdominal surgery.

Incarcerated incisional hernia of the sigmoid colon after appendectomy: A case report

“…In the present case, although the patient had several risk factors for incisional hernia such as old age, male, and diabetes mellitus, incisional hernia of the sigmoid colon is rare because the radius of the colon is larger than that of the small bowel and the colon is less redundant. Moreover, since the muscles in the abdominal wall play an important role in preventing herniation following a McBurney incision, the present case is extremely rare when considering the probability of colonic incisional hernia through a McBurney incision following appendectomy [5]. In the English literature, the present case is the fourth case of incisional hernia of the colon after abdominal surgery (Table 1) and the first case of incisional hernia of the colon after appendectomy.…”

“…The small bowel and omentum are commonly herniated organs, but unusual organs such as the bladder and colon may herniate through the abdominal wall defect [5], [6], [7], [8]. The ascending and descending colon are fixed into the retroperitoneum, whereas the transverse and sigmoid colon are not, which can allow these bowel segments to herniate through a weak abdominal wall just as small bowel loops do.…”

Urinary bladder diverticulum as an unusual content of the inguinal canal

“…In case of incisional bladder hernia, a previous therapy with steroids, diabetes mellitus, chronic obstructive pulmonary disease, inappropriate technical procedure used for wound closure during previous operations and postoperative complications like wound infections and ileus have been postulated [10]. Irrespective of the contents of the inguinal canal, the treatment is identical and usually involves a surgical mesh placement.…”