PMC3224069_01
A pre-operative view of the abdomen of our patient showing the massive abdominal distension localized to the right side
PAMJ-10-18-g001.jpg
PMC3224069_01_PAMJ-10-18-g001.jpg
F0001
There is diffuse abdominal distension and a huge painful non reducible mass of the right side of the abdomen (Figure 1), exquisitely tender on palpation.
An intra-operative view of the abdomen of our patient showing extensive small bowel necrosis
PAMJ-10-18-g002.jpg
PMC3224069_01_PAMJ-10-18-g002.jpg
F0002
Exploration shows a massive incisional hernia (hernia orifice is measured at 23 cm) with incarceration and necrosis of 135 cm of small bowel (Figure 2).
A view of the hernia repair. The non absorbable polypropylene mesh is placed pre-muscular, behind the rectus sheath
PAMJ-10-18-g003.jpg
PMC3224069_01_PAMJ-10-18-g003.jpg
F0003
A pre-peritoneal 30x30 cm non absorbable polypropylene mesh is placed to repair the incisional hernia (Figure 3).