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Flank pseudohernia following posterior rib fracture: a case report

BACKGROUND: A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia...

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Autores principales: Butensky, Adam M., Gruss, Leah P., Gleit, Zachary L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045639/
https://www.ncbi.nlm.nih.gov/pubmed/27716425
http://dx.doi.org/10.1186/s13256-016-1054-9
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author Butensky, Adam M.
Gruss, Leah P.
Gleit, Zachary L.
author_facet Butensky, Adam M.
Gruss, Leah P.
Gleit, Zachary L.
author_sort Butensky, Adam M.
collection PubMed
description BACKGROUND: A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. CASE PRESENTATION: A case of pseudohernia due to fractures of the 10(th) and 11(th) ribs in a 68-year-old white woman is presented. The patient suffered from a major coughing episode 1 year prior to her presentation, after which she noted a progressively enlarging bulge in her left flank. Computed tomography demonstrated a bulge in the abdominal wall containing bowel and spleen but with all muscle and fascial layers intact; in addition, lateral 10(th) rib and posterior 11(th) rib fractures were noted. CONCLUSIONS: As there was no defect in muscle or fascia, we diagnosed a pseudohernia, likely due to a denervation injury from the fractured ribs. Symptomatic treatment was recommended, including wearing a corset and referral to a pain management clinic. Symptomatic treatment is thought to be the mainstay of therapy for pseudohernias, as surgical intervention is unlikely to be of benefit.
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spelling pubmed-50456392016-10-12 Flank pseudohernia following posterior rib fracture: a case report Butensky, Adam M. Gruss, Leah P. Gleit, Zachary L. J Med Case Rep Case Report BACKGROUND: A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. CASE PRESENTATION: A case of pseudohernia due to fractures of the 10(th) and 11(th) ribs in a 68-year-old white woman is presented. The patient suffered from a major coughing episode 1 year prior to her presentation, after which she noted a progressively enlarging bulge in her left flank. Computed tomography demonstrated a bulge in the abdominal wall containing bowel and spleen but with all muscle and fascial layers intact; in addition, lateral 10(th) rib and posterior 11(th) rib fractures were noted. CONCLUSIONS: As there was no defect in muscle or fascia, we diagnosed a pseudohernia, likely due to a denervation injury from the fractured ribs. Symptomatic treatment was recommended, including wearing a corset and referral to a pain management clinic. Symptomatic treatment is thought to be the mainstay of therapy for pseudohernias, as surgical intervention is unlikely to be of benefit. BioMed Central 2016-10-01 /pmc/articles/PMC5045639/ /pubmed/27716425 http://dx.doi.org/10.1186/s13256-016-1054-9 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Butensky, Adam M.
Gruss, Leah P.
Gleit, Zachary L.
Flank pseudohernia following posterior rib fracture: a case report
title Flank pseudohernia following posterior rib fracture: a case report
title_full Flank pseudohernia following posterior rib fracture: a case report
title_fullStr Flank pseudohernia following posterior rib fracture: a case report
title_full_unstemmed Flank pseudohernia following posterior rib fracture: a case report
title_short Flank pseudohernia following posterior rib fracture: a case report
title_sort flank pseudohernia following posterior rib fracture: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045639/
https://www.ncbi.nlm.nih.gov/pubmed/27716425
http://dx.doi.org/10.1186/s13256-016-1054-9
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