Abstract
Although an incisional hernia is a common complication after abdominal surgery, a hernia with abdominal rupture is rare. Surgical meshes are widely used in giant incisional hernia repair. However, meshes should not be used in contaminated surgery. The component separation method is useful for giant hernia repair and does not need artificial materials such as mesh. A case of an 83-year-old woman who had an incisional hernia with abdominal rupture is reported. Although she was diagnosed with an abdominal wall incisional hernia 1 year after sigmoidectomy, she did not undergo surgical hernia repair. Nine years after the operation, she was brought to our hospital with intestinal prolapse. She noticed her bowel outside her abdominal cavity after defecation. The hernia orifice was very large (82mm), but the wound area was contaminated, and toilet paper was attached to the intestine. Intestinal resection was needed, and mesh could not be used. Thus, hernia repair using the component separation method was planned. The patient's postoperative course was uneventful, and she was discharged on postoperative day 38. She had no recurrence of the incisional hernia 6 months after operation. The component separation method could be useful for the emergency case with a very large hernia and a contaminated surgical site.
