An Operated Case of Median Epigastric Hernia.

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  • 正中腹壁ヘルニアの１例

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Abstract

A 75-year-old woman was seen at the clinic because of an epigastric mass. The tumor was about egg-sized and elastic soft with mild tenderness. We thought that the tumor was a ventral hernia because it enlarged with abdominal pressure. It penetrated the linea alba and reached under the skin on abdominal ultrasonography and CT. We diagnosed the case as a median ventral hernia. Upon laparotomy, there were herniated preperitoneal fat and a hernial sac from the linea alba. We peeled them off, excised the sac, repaired the linea alba with two layers, and laid Marlex mesh on the linea alba. It is thought that principles of the operation are resection of hernial sac and the herniorrhaphy. Some were reported as the operative methods: simple closure of the hernial gate, suturing an incision line upon the sheath of rectus abdominis muscle, and suturation two layers of anterior and posterior sheaths of rectus abdominis muscle. Median epigastric hernia is comparatively rare in Japan. We present 50 cases including our case, of which details have been clearly reported in this country, with some bibliographical consideration.

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