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Umbilical Varix Herniating Through Umbilical Defect and Mimicking Incarcerated Hernia
Grigoriy V. Klimovich,Minjeong Kwon,Jenna L. Klimovich,Edward B. Lineen 대한외상중환자외과학회 2016 Journal of Acute Care Surgery Vol.6 No.2
The patient is a 43-year-old male with medical history significant for severe alcoholic cirrhosis who presented with a one-month history of periumbilical pain. The patient did not have any symptoms of bowel obstruction. Physical examination revealed an umbilical defect containing an intra-abdominal structure, mimicking incarcerated umbilical hernia. Computed tomo-graphy revealed an engorged, umbilical varix 1.6 cm in diameter, herniating through the umbilical defect. No surgical intervention was offered for this patient and medical manage-ment for varix resulted in clinical resolution in three months. (J Acute Care Surg 2016;6:71-72)
Grigoriy V. Klimovich,Randal Zhou,Kurt E. Roberts 대한외상중환자외과학회 2020 Journal of Acute Care Surgery Vol.10 No.3
A 51-year-old female underwent recurrent open incisional hernia repair with retrorectus meshplacement. Early in the post-operative course, she developed a hernia reoccurrence secondary tobreakdown of the staple line, at the level of the posterior rectus sheath, resulting in a small bowelobstruction. This hernia could not be felt upon physical examination but was detected by imaging. The patient was promptly taken to the operating room for laparoscopic reduction of the incarceratedloop of small intestine, along with laparoscopic repair of the posterior rectus sheath defect. It iscritical for surgeons to recognize the possibility of a staple line breakdown at the level of posteriorrectus sheath early on in the diagnosis which would prompt urgent surgical intervention in thesetting of a bowel obstruction.