case_images: PMC3599755_01
case_images: Soft tissue gas of the right abdominal wall.
case_images: 1752-1947-7-5-1.jpg
case_images: PMC3599755_01_1752-1947-7-5-1.jpg
case_images: F1
case_images: Computed tomography identified massive right torso soft tissue gas extending from the costal margin to inguinal canal (midline to the back) (Figure  1).
case_images: Intact transversus abdominus layer following resection of the external and internal oblique aponeuroses, rectus muscles, and a portion of the pectoralis muscle.
case_images: 1752-1947-7-5-2.jpg
case_images: PMC3599755_01_1752-1947-7-5-2.jpg
case_images: F2
case_images: Immediate antimicrobial support and operative intervention led to resection of the entire external oblique and transversus abdominus aponeuroses, rectus muscles, and a portion of the pectoralis muscle of the patient's right torso (Figure  2).
case_images: Large triangular skin flaps.
case_images: 1752-1947-7-5-3.jpg
case_images: PMC3599755_01_1752-1947-7-5-3.jpg
case_images: F3
case_images: The internal oblique aponeurosis and two large triangular skin flaps were left intact (Figure  3).
case_images: Reconstruction of the abdominal wall with 2 large pieces of biologic graft.
case_images: 1752-1947-7-5-4.jpg
case_images: PMC3599755_01_1752-1947-7-5-4.jpg
case_images: F4
case_images: The final closure utilized two large pieces of biologic material (Strattice , LifeCell Inc., New Jersey, USA) to prevent subsequent hernia formation (Figure  4).
case_images: Closure of skin flaps over the abdominal wall reconstruction.
case_images: 1752-1947-7-5-5.jpg
case_images: PMC3599755_01_1752-1947-7-5-5.jpg
case_images: F5
case_images: The two large skin and soft tissue flaps were then closed (Figure  5).
case_images: Abdominal wall 12 months after the reconstruction.
case_images: 1752-1947-7-5-6.jpg
case_images: PMC3599755_01_1752-1947-7-5-6.jpg
case_images: F6
case_images: His 12-month out-patient follow-up continues to show no obvious hernia or attenuation in his abdominal wall (Figure  6).