Interparietal Hernia Presenting as Acute Intestinal Obstruction: A Case Report

Abstract

Interparietal hernias are a few and infrequent type of abdominal wall hernias where the herniated viscera is located between the musculoaponeurotic layers of the anterior abdominal wall. The hidden anatomic location commonly causes time loss in diagnosis, and the presentation also is commonly complicated by the scenario of intestinal obstruction. The present report discusses a 67-year-old woman who came to the clinic with acute pain and distension in the abdomen, vomiting, and no bowel movements. Contrast enhanced computed tomography showed loops of the small bowel hernias through an inferior midline abdominal wall defect above the pubic symphysis. Emergency exploratory laparotomy was made to establish an interparietal hernia which was located below the arcuate line, and the distal jejunal and ileal loops were incarcerated. It was a viable bowel that was successfully reduced and a mesh repair of the bowel was done to seal the defect. The follow-up postoperative period was complication-free and the patient did not suffer any symptoms. This case emphasizes the significance of the consideration of interparietal hernia in patients with unexplained intestinal obstruction and a history of abdominal surgery, and the significance of computed tomography in the diagnosis of the condition preoperative diagnosis. Diagnosis and treatment are easy on realization.