Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1721-1728
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1721
Giant ventral hernia simultaneously containing the spleen, a portion of the pancreas and the left hepatic lobe: A case report
Xia-Gang Luo, Chen Lu, Wu-Lin Wang, Fei Zhou, Chun-Zhao Yu
Xia-Gang Luo, Chen Lu, Wu-Lin Wang, Fei Zhou, Chun-Zhao Yu, Department of General Surgery, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 2l0011, Jiangsu Province, China
Author contributions: Luo XG wrote the paper; Lu C, Wang WL, Zhou F collected the data and relevant images; Yu CZ revised the paper.
Supported by the National Natural Science Foundation of China, No. 81172269 and No. 30972910; Jiangsu Provincial Commission of Health and Family Planning, No. Z201603; Youth talent support program of Nanjing City during the 13th Five-Year Plan Period, No. QRX17107; Natural Science Fund of Nanjing Medical University, No. 2017NJMU041.
Informed consent statement: Informed consent was obtained before any medical investigation or initiation of treatment as required.
Conflict-of-interest statement: The authors declare no conflict of interest.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chun-Zhao Yu, MD, PhD, Professor, Department of General Surgery, the Second Affiliated Hospital of Nanjing Medical University, No. 121 Jiangjiayuan Road, Nanjing 2l0011, Jiangsu Province, China. chunzhaoyu@njmu.edu.cn
Received: December 28, 2019
Peer-review started: December 28, 2019
First decision: January 19, 2020
Revised: March 27, 2020
Accepted: April 17, 2020
Article in press: April 17, 2020
Published online: May 6, 2020
Processing time: 124 Days and 0.5 Hours
Abstract
BACKGROUND

Ventral hernia, also known as incisional hernia, is a common complication of previous surgery. The contents of ventral hernia may include omentum, preperitoneal fat, small intestine or colon. However, ventral hernia with protrusion of more than two parenchymal organs simultaneously is extremely rare, and its repair is very complex and difficult. Surgeons should make a comprehensive assessment based on their own experience and the individual characteristics of the hernia. In addition, psychological therapy should be emphasized in the whole treatment process.

CASE SUMMARY

We report a rare case of asymptomatic giant ventral hernia for 15 years in a 21-year-old female. The patient underwent umbilical hernia repair at the age of 1 year. Approximately 5 years later, ventral hernia recurred and repair with Mesh was performed, but the operation failed due to postoperative infection, and a huge mass appeared in the left abdominal wall. The mass increased gradually with the development and maturity of the body. Computerized tomography scan demonstrated that the patient's total spleen, part of the pancreas and left lobe of the liver were simultaneously herniated through the abdominal incisional hernia. As the patient was unable to endure the inconvenience of life and the potential risk of spleen or liver rupture, she underwent a ventral hernia repair with Mesh at our hospital. The operation was successful and the patient had a good recovery. During a 3-mo follow-up, the patient remained asymptomatic and the appearance of the surgical incision was greatly improved.

CONCLUSION

Ventral hernia is a common complication of abdominal surgery. Ventral hernia with protrusion of more than two parenchymal organs simultaneously is extremely rare. Surgeons should pay attention to the psychological treatment while restoring the abdominal physiological function in ventral hernia patients.

Keywords: Giant ventral hernia, Spleen, Pancreas, Liver, Mesh, Case report

Core tip: We report a rare case of giant ventral hernia simultaneously containing the spleen, a portion of the pancreas and the left hepatic lobe. Abdominal parenchymal organs such as liver, spleen and pancreas are rarely found in the ventral hernia either separately or simultaneously. Surgeons should pay attention to the psychological treatment while restoring the abdominal physiological function in ventral hernia patients.