Post-cholecystectomy Incisional Hernia With Gastric Outlet Obstruction.

Abstract

An incisional hernia is a common complication after abdominal surgery. The omentum and small bowel are the most commonly herniated intra-abdominal structures through the fascial defect; however, involvement of the stomach in incisional hernia causing gastric outlet obstruction is very rare. We report a case of a 50-year-old female patient who presented with symptoms of intermittent nausea, vomiting, abdominal swelling, and postprandial discomfort. Clinical examination and imaging revealed an incisional hernia containing an antral part and greater curvature of the stomach, causing gastric outlet obstruction. Reduction of the herniated contents, defect closure, and on-lay mesh placement resulted in the resolution of symptoms. Gastric outlet obstruction secondary to incisional hernia is more frequently observed in middle-aged elderly patients who have had previous abdominal procedures and in women with multiple pregnancies. Contrast-enhanced computed tomography (CECT) plays a crucial role in the diagnosis. Surgical repair remains the definitive treatment for hernias to prevent complications. This case highlights the need to consider incisional hernias with gastric herniation as a potential cause for gastric outlet obstruction, especially in patients of geriatric age. Early diagnosis and surgical treatment are important to relieve symptoms and reduce the risk of complications.