Irregularly shaped abdominal mass
Four years earlier, our patient had multiple abdominal surgeries. Now he had a nontender mass that was growing…and growing.
Ultrasound or CT scan is diagnostic
After a thorough history and physical examination, ultrasonography or CT often helps differentiate a ventral hernia from other abdominal wall defects. In patients with a ventral hernia, either imaging modality will demonstrate prolapsed loops of hollow viscus.
A CT scan was not an option for our patient because none of the local machines could accommodate the size and shape of his body. He had an abdominal ultrasound instead.
Surgery sets things right
Treatment of a ventral hernia involves either an open or laparoscopic surgical correction, often with the placement of a supportive mesh4 (SOR: B, inconsistent or limited-quality patient-oriented evidence). Repair of epigastric hernias is crucial even in asymptomatic patients due to the high rate of incarceration.3
Our patient was referred to a hernia specialty clinic at a nationally recognized medical center. He moved out of state shortly thereafter and was lost to follow-up.
CORRESPONDENCE
William Murdoch, MD, WSU/Crittenton Family Medicine Residency, 1135 West University Drive, Suite #250, Rochester Hills, MI 48307; bmurdoch@med.wayne.edu
