Abstract
A 38-year-old pregnant female presented to our hospital because of swelling of her upper abdomen. She had a history of gastroschisis and was diagnosed with incisional hernia at the upper edge of the midline scar. She was in late pregnancy and asymptomatic except the swelling so that we decided to follow the clinical course. After childbirth, she presented again because of enlarging swelling and abdominal pain due to the hernia. Abdominal contrast-enhanced CT findings showed incarceration of the omentum and an abscess within the hernia sac. Following incisional drainage of the abscess, antibiotic medication was started in our clinic. After the inflammation subsided, we performed a hernia plastic surgery under general anesthesia and found an adherent appendix within the hernia sac. Based on clinical and operative findings, the diagnosis of incarcerated incisional hernia associated with malrotation of the intestine was made. Appendix-associated incisional hernia at the midline of the abdominal scar is very rare and it is necessary to make prudent pre-operative diagnosis and anatomical understanding, if malrotation of the intestine is associated like in this case.
