Irreducible primary ventral abdominal hernia containing segment III of the liver: A case report

INTRODUCTION AND IMPORTANCE: Herniation of the liver through the anterior abdominal wall is extremely rare entity; majority of cases are from incisional hernia after upper abdominal or cardiac surgery. CASE PRESENTATION: A 42-year-old woman who is known to have asthma presented to our emergency unit with, vomiting, epigastric pain, and swelling of 12 h duration. Upon examination, we found a mildly tender and irreducible epigastric abdominal swelling. Clinically, SBO (small bowel obstruction) secondary to irreducible epigastric hernia was suspected and abdominal ultrasound and non-contrast CT scan was done. Both ultrasound and CT revealed an epigastric hernia containing segment III of the liver. She underwent an emergent abdominal exploration that included non-anatomic resection of segment III of the liver and tissue-based hernia repair. CLINICAL DISCUSSION: Primary anterior liver hernia is herniation of the liver through the anterior abdominal wall defect in the absence of a previous abdominal incision. Diagnosis requires imaging studies such as abdominal ultrasound and CT scan. The management depends on the patient presentation, if there is any complication like vascular compromise and injury to herniated liver. CONCLUSION: Primary liver hernia through the anterior abdominal wall is extremely rare entity. To the best of our knowledge, only four cases of primary anterior liver hernia have been described in the literature.