A case of incarcerated epigastric hernia in a patient receiving regular steroid therapy

Abstract

The present patient was a 49-year-old man who had been receiving corticosteroid therapy for psoriasis vulgaris since 1998. The patient visited our hospital after developing abdominal pain and umbilical swelling in December 2004. Emergency surgery was performed following a diagnosis of incarcerated umbilical hernia based on ultrasound and CT findings.
Intraoperative findings included a defect in the linea alba cranial to the umbilicus in addition to presence of a hernia sac in this defect and prolapse and incarceration of hernia contents. The patient was diagnosed with incarcerated epigastric hernia based on these findings. Only simple closure was performed for the hernia orifice because the surrounding tissue was relatively rigid and the tension was mild. Presently, after approximately 2.5 years of postoperative follow-up, no signs of relapse have been confirmed.
Epigastric hernia is considered a relatively rare disease in Japan. In the present study, we report our experience with a case of incarcerated epigastric hernia that was thought to have resulted primarily from long-term corticosteroid therapy with reference to literature.