Escandón EYM, Arizmendi BJ, González AMA, Vásquez GH, Cruz SMÁ, Esquivel LIJ

Language: Spanish
References: 8
Page: 141-145
PDF size: 355.73 Kb.

ABSTRACT

Perineal hernia is a protrusion of the pelvic viscera or fat through a defect in the muscles and fascia of the pelvic floor, they can be classified by their origin as primary or secondary; and by their position in front and rear. Lateral perineal hernias are more common in women, especially front hernias, also known as "labia" or "genital" hernia. They are favored by multiparity, obesity, ascites and repeated perineal infections and old age, as well as in women with a history of multiple gynecological operations, mainly for prolapse. We report the case of a 33-year-old woman, who presented increased volume in the perineal region in a saccular manner, of 18 months of evolution. To do diagnosis a perineal ultrasonography and a computed tomography were done, which showed an aponeurotic defect of 2 inches in diameter, of vascular and fat content. Defect was repaired with resection of the sac and of a prehernia lipoma (with ligation at the base) and the application of polypropylene mesh plug fixed with 2-0 polypropylene, the patient is currently asymptomatic and without recurrence at six months of follow-up.

REFERENCES

1. Pélissier E, Ngo P, Armstrong O. Tratamiento quirúrgico de las hernias perineales laterales. EMC-Técnicas Quirúrgicas-Aparato Digestivo 2010;26(2):1-5.

2. Padilla LR, Marinez MA, Quijano OF, Zavala RJ, Valerio UJ. Tension free perineal hernioplasty: report of a case. Hernia 1999;4:221-223.

3. Koontz AR. Perineal hernia; report of a case with many associated muscular and fascial defects. Ann Surg 1951;133(2):255-260.

4. Flikier Gotlib J, Valverde Monge C, Flikier Zelkowicz B. Hernia perineal posoperatoria: reporte de un caso. Acta Médica Costarricense 2001;43(3):141-142.

5. De Campos FG, Habr-Gama A, Araújo SE, Sousa AH Jr, et al. Incidence and management of perineal hernia after laparoscopic proctectomy. Surg Laparosc Endosc Percutan Tech 2005;15(6):366-370.

6. Ryan S, Kavanagh DO, Neary PC. Laparoscopic repair of postoperative perineal hernia. Case Report Med 2010;2010 Aug 9.

7. Wasserberg N, Kaufman HS. Lumbar and pelvic hernias. In: Yeo CJ, Dempsey DT, Klein AS, editors. Shackelford’s surgery of the alimentary tract. 6th ed. Philadelphia: WB Saunders, 2007.

8. Araki Y, Noake T, Nagae T, Tou Y, et al. Perineal hernia in women: assessment with evacuation fluoroscopic cystocolpoproctography. Kurume Med J 2007;54(3-4):51-55.