A rare type of postoperative abdominal herniation

Abstract

Resume. Postoperative abdominal hernia is considered the most common complication in abdominal surgery. Aim. To acquaint medical practitioners with the clinical case of diagnosis and treatment of impaired postoperative contraperture true abdominal hernia on the background of a closed abdominal injury. Materials and methods. We present a clinical case of our own observation of the clinical course, diagnosis and treatment of impaired postoperative contraperture true abdominal hernia with necrosis of the loop of the small intestine and necrosis of the large omentum, acute strangulation small intestinal obstruction, general serous-fibrinous peritonitis, adhesive peritoneal disease of the 2nd degree at patient with closed abdominal trauma. Results. The patient with a closed abdominal injury, the results of the examination and treatment of which are given in the article, in the anamnesis - cholecystoectomy 39 years ago. The preliminary diagnosis: closed abdominal trauma, peritonitis. Intraoperatively, a case of true postoperative abdominal hernia of rare localization - contraperture hernia. It was taking into account the patient's complaints, medical history, results of physical examination, the results of laboratory and instrumental methods of research available at the time of examination. The clinical interest is not only the rarity of the birth of this pathology, but also the history of the disease, diagnostic search, clinical picture and treatment tactic. Conclusions. In this case, the patient was probably a hernia carrier for many years, and the injury only provoked the infringement. The patient sought medical help late, as result of which the picture of peritonitis was obvious. This made it possible to quickly decide on the need for surgical treatment. Otherwise, the likelihood of a tactical error is not excluded. We believe this case is interesting because one should always remember about the possible surgical pathology against the background of a closed abdominal trauma.