Successful management of strangulated incisional hernia in pregnancy — A case report

INTRODUCTION: Abdominal hernias, including incisional hernias, can occur due to weakness in the abdominal wall. Incisional hernias commonly occur following surgical incisions, and factors such as poor closure technique and patient-related factors can contribute to their development. CASE PRESENTATION: In this case, the patient was presented with a painful, irreducible lump over a previous laparotomy scar, along with bowel obstruction symptoms. The diagnosis was supported by ultrasound findings showing obstructed bowel loop in the hernial sac. Emergency open surgical reduction and mesh repair were performed to treat the strangulated hernia and ensure the mother and fetus's safety. The patient had an uneventful postoperative period and was discharged after three days. DISCUSSION: Incisional hernias can be diagnosed through clinical evaluation, and imaging studies may be necessary in complex cases. However, imaging techniques such as X-rays and Computed Tomography scans are limited in pregnant women due to the radiation risks. Ultrasonography (USS) is preferred in pregnant women for its safety and non-invasiveness, although it may have reduced sensitivity in obese patients. Complicated hernias should be treated with emergency surgical repair, while elective surgery can be considered for asymptomatic or non-complicated hernias. Laparoscopic surgery offers advantages such as shorter hospital stays and fewer complications. Mesh repair reduces the recurrence risk in subsequent pregnancies (relate the discussion with the case). CONCLUSION: Overall, surgical management of hernias in pregnancy requires careful consideration of individual circumstances and the use of appropriate techniques to ensure the safety of both the mother and fetus.