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Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease

Perineal hernia is a rare complication of pelvic surgeries that can occur in patients with perianal Crohn's disease (pCD) as a long-term outcome of surgeries for complex fistula treatment. We present a case of a symptomatic pCD male patient with multiple perianal surgeries who presents with ana...

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Autores principales: Garuba, Favour O., McPhie, Josh M., Anolik, Rachel A., Deepak, Parakkal, Ballard, David H., Smith, Radhika K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483503/
https://www.ncbi.nlm.nih.gov/pubmed/37691760
http://dx.doi.org/10.1016/j.radcr.2023.08.071
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author Garuba, Favour O.
McPhie, Josh M.
Anolik, Rachel A.
Deepak, Parakkal
Ballard, David H.
Smith, Radhika K.
author_facet Garuba, Favour O.
McPhie, Josh M.
Anolik, Rachel A.
Deepak, Parakkal
Ballard, David H.
Smith, Radhika K.
author_sort Garuba, Favour O.
collection PubMed
description Perineal hernia is a rare complication of pelvic surgeries that can occur in patients with perianal Crohn's disease (pCD) as a long-term outcome of surgeries for complex fistula treatment. We present a case of a symptomatic pCD male patient with multiple perianal surgeries who presents with anal pain, diarrhea, and discharge. Magnetic resonance imaging showed a perineal hernia in the ischioanal fossa violating the convergence of the left external sphincter complex. The hernia was treated with an open primary hernia repair via the perineal approach. It recurred after 3 months, and the patient underwent secondary hernia repair with gracilis muscle interposition and mesh placement. Unfortunately, this was complicated by superficial skin dehiscence and mesh extrusion, but the flap remained viable and the hernia repair was intact. Incidence, symptoms, risk factors, imaging findings, and management of perineal hernias are reviewed.
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spelling pubmed-104835032023-09-08 Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease Garuba, Favour O. McPhie, Josh M. Anolik, Rachel A. Deepak, Parakkal Ballard, David H. Smith, Radhika K. Radiol Case Rep Case Report Perineal hernia is a rare complication of pelvic surgeries that can occur in patients with perianal Crohn's disease (pCD) as a long-term outcome of surgeries for complex fistula treatment. We present a case of a symptomatic pCD male patient with multiple perianal surgeries who presents with anal pain, diarrhea, and discharge. Magnetic resonance imaging showed a perineal hernia in the ischioanal fossa violating the convergence of the left external sphincter complex. The hernia was treated with an open primary hernia repair via the perineal approach. It recurred after 3 months, and the patient underwent secondary hernia repair with gracilis muscle interposition and mesh placement. Unfortunately, this was complicated by superficial skin dehiscence and mesh extrusion, but the flap remained viable and the hernia repair was intact. Incidence, symptoms, risk factors, imaging findings, and management of perineal hernias are reviewed. Elsevier 2023-09-04 /pmc/articles/PMC10483503/ /pubmed/37691760 http://dx.doi.org/10.1016/j.radcr.2023.08.071 Text en © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Garuba, Favour O.
McPhie, Josh M.
Anolik, Rachel A.
Deepak, Parakkal
Ballard, David H.
Smith, Radhika K.
Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease
title Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease
title_full Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease
title_fullStr Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease
title_full_unstemmed Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease
title_short Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease
title_sort perineal hernia as a sequela of anal reconstruction surgeries in perianal crohn's disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483503/
https://www.ncbi.nlm.nih.gov/pubmed/37691760
http://dx.doi.org/10.1016/j.radcr.2023.08.071
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