Chou YC. Parietal peritoneal hernia after abdominal hysterectomy for forty years: A case report. World J Clin Cases 2025; 13(11): 98570 [DOI: 10.12998/wjcc.v13.i11.98570]
Corresponding Author of This Article
Ya-Chen Chou, MD, Division of General Surgery and Department of Surgery, Kaohsiung Municipal Feng Shan Hospital (Under the Management of Chang Gung Medical Foundation), No. 42 Jingwu Road, Fengshan District, Kaohsiung 830025, Taiwan. bameow@cgmh.org.tw
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2025; 13(11): 98570 Published online Apr 16, 2025. doi: 10.12998/wjcc.v13.i11.98570
Parietal peritoneal hernia after abdominal hysterectomy for forty years: A case report
Ya-Chen Chou
Ya-Chen Chou, Division of General Surgery and Department of Surgery, Kaohsiung Municipal Feng Shan Hospital (Under the Management of Chang Gung Medical Foundation), Kaohsiung 830025, Taiwan
Ya-Chen Chou, Division of General Surgery and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan
Author contributions: Chou YC contributed to data collection, data analysis and drafting of the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Chen Chou, MD, Division of General Surgery and Department of Surgery, Kaohsiung Municipal Feng Shan Hospital (Under the Management of Chang Gung Medical Foundation), No. 42 Jingwu Road, Fengshan District, Kaohsiung 830025, Taiwan. bameow@cgmh.org.tw
Received: June 30, 2024 Revised: October 28, 2024 Accepted: December 6, 2024 Published online: April 16, 2025 Processing time: 179 Days and 0.2 Hours
Abstract
BACKGROUND
Internal hernia is a rare complication following abdominal surgery, primarily resulting from structural defects caused by anastomosis. We report a unique case of a late abdominal wall internal hernia highly suspected as resulting from insufficient peritoneal closure.
CASE SUMMARY
A 72-year-old woman presented with symptoms of intestinal obstruction 40 years after undergoing an abdominal hysterectomy. Abdominal computed tomography revealed a suspicious closed loop of intestine; then, a laparotomy was performed for suspected internal hernia. During the procedure, herniation of intestine into the preperitoneal space through a parietal peritoneal defect between rectus abdominis and sigmoid colon was identified. Intestinal reduction, resection of the ischemic segment and closure of the peritoneal defect were performed. The patient recovered well.
CONCLUSION
Non-closure of peritoneum might lead to late internal hernias. Meticulous peritoneal closure should be considered to prevent this potentially lethal complication.
Core Tip: We report a unique case of an abdominal wall internal hernia, a late complication that is highly suspected to be related to insufficient peritoneal closure. In the context of the current dominant practice of not closing the peritoneum, our case highlights a potential challenge in lower abdominal surgeries, particularly those involving organ resection or transabdominal preperitoneal inguinal herniorrhaphy. It emphasizes the need for heightened awareness among clinicians regarding long-term surgical outcomes, and advocates for meticulous peritoneal closure to prevent this potentially lethal issue, despite the limited existing evidence.
