Giant Ventral Hernia in a Pregnant Patient

Abstract

Large abdominal wall defects can occur as a result of temporary abdominal closure (TAC). TAC is used in critically ill patients where the abdominal wall cannot be closed due to intraabdominal hypertension, loss of domain (LOD), and other devastating abdominal conditions. Clinically, TAC is similar to giant ventral hernias (GVH) in that both have large facial defects. In the setting of pregnancy GVH is uncommon. In a meta-analysis of pregnant patients only five ventral hernias were described among nearly 33,000 patients [1]. Similarly, pregnancy in the setting of TAC is exceptionally rare. Our review of the literature did not identify other cases of TAC followed by a pregnancy. The literature does contain one case in which a pregnant woman suffered abdominal trauma and was managed with TAC [2]. In this report, we present the case of a woman who sustained penetrating abdominal trauma, received treatment with TAC, failed to return to clinic, then subsequently re-presented with a second trimester gestation.