Ventral incisional hernia with herniation of the left hepatic lobe: A case report

Abstract

Incisional hernias are a very common complication of abdominal surgery, reaching form 5–20% to around 69% in the case of high-risk patients with prospective long-term follow-up. Herniation of the liver, however, is extremely rare and there are only a handful of cases reported. Here we present a case concerning a complex incisional defect of the abdominal wall involving liver herniation with mild ischemia that required extensive surgery to repair in a patient with previous history of ovarian cancer with incomplete resection surgery. The treatment choice was manual reduction of the hernia at the moment of presentation and delayed elective surgery for definite correction, aiming at full functional recovery of the abdominal wall muscles and to a better outcome regarding quality of life when compared to mesh repair without closure of the defect. As hernias involving left hepatic lobe are rare and mostly occur in patients with comorbidities, conservative management should be considered. However, depending on the effect they have in quality of life, preoperative conditions should be optimized aiming for a successful abdominal wall reconstruction, despite the patient’s comorbidities.