INCISIONAL HERNIA IN PREGNANCY A SILENT BUT POTENTIAL FATALITY – CASE REPORT


INCISIONAL HERNIA IN PREGNANCY A SILENT BUT POTENTIAL FATALITY – CASE REPORT


Jombo SE*1, Emejulu CI 2, Obi RA1, Onwusulu DN1, Iloh AA2, Ilikannu SO1
1Department of Obstetrics and Gynaecology, FMC, Asaba
2General Surgery Unit,   Department of Surgery, FMC, Asaba.


Rupture of incisional hernia, with consequent emergency laparotomy and repair, is an uncommon complication of pregnancy. The risk to the mother and baby is enormous. We present an un-booked 29 year old G4P2+1 (1- alive) with one previous caesarean section at 29 weeks of gestation. She had a huge anterior abdominal wall incisional hernia with gravid uterus as content. She was admitted on conservative management on account of abdominal pain and preterm contractions, but subsequently developed spontaneous rupture from an ulcer with bowel evisceration. She had emergency laparotomy and repair but unfortunately had unavoidable bowels injury as they were morbidly adherent to the anterior abdominal wall with injury necessitating resection and re-anastomosis with caesarean section. The neonate suffered early neonatal death. The presence of ulceration may be a predictor of adverse maternal and foetal outcome


Keywords: Incisional hernia in pregnancy, ulceration, emergency laparotomy, bowel resection and anastomosis, caesarean section.

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How to cite this article:
Jombo SE, Emejulu CI, Obi RA, Onwusulu DN, Iloh AA, Ilikannu SO.INCISIONAL HERNIA IN PREGNANCY A SILENT BUT POTENTIAL FATALITY – CASE REPORT. American Journal of Surgical Research and Reviews, 2020, 3:8. DOI:10.28933/ajsrr-2019-11-0607


References

1. Snehamay C, Senkar NM, Abhiskek D and Debasish B. Gravid uterus in an anterior abdominal wall hernia and successful repair at the time of caesarean section. BJMP 2009; 2(4):57-58
2. Eleje GU, Okpala BC, Enendu SE, Okeke PM and Ejikeme TB. Herniated near term pregnancy through an incisional hernia treated with polypropylene mesh: A case report. Niger Med J. 2014; 55(3): 271-273
3. Palazzo F, Regazzi S, Ferrara D, Pazza D. Herniated gravid uterus through an incisional hernia treated with component separation technique. Hernia. 2010; 14: 101-4
4. Dasgupta S. Incisional hernia in pregnancy. Int J User-Driven health care. 2012; 2: 60-2
5. De U, Ray R. Spontaneous rupture of incisional hernia associated with pregnancy. SurgPract. 2008; 12: 97-8
6. Ozaki K, Tanimura K, Ebina Y, Kanemitsu K and Yamada H. A pregnant woman with a surgical site infection after mesh repair of an abdominal wall incisional hernia: a case report: Journal of medical case reports 2017; 11:66
7. Malhotra M, Sharma JB, Wadhwa L, Arora R. Successful pregnancy outcome after caesarean section in a case of gravid uterus growing in an incisional hernia of the anterior abdominal wall. Indian J Med Sci. 2003; 57:501-3
8. Adesunkanmi AR, Faleyimu B. Incidence and aetiolgical factor of incisional hernia post caesarean operation in a Nigerian Hospital. J. Obstet Gynaecol.2003; 23:258-60.
9. Ndubuisi E. Spontaneous rupture of an incisional hernia. Highland Medical Journal. 2006; 4: 86-88.
10. Caser K, Munro A. Surgical treatment of incisional hernia. Br J Surg. 2002; 89: 534-45
11. Wai PY, Ruby JA, Davis KA, Roberts AC, Roberts KE. Laparoscopic ventral hernia repair during pregnancy. Hernia. 2009; 13(5): 559-63
12. Palanivelu C, Rangarajan M, Senthikumaram S, Parthasarathi R. Safety and efficacy of laparoscopic surgery in pregnancy: Experience of a single institution. J laparoendoscAdvSurg Tech A. 2007; 17:186-90