case_images: PMC7315276_01
case_images: A 5 cm vertical surgical scar is present distal to the umbilicus. Significant midline abdominal bulging is noted to extend beyond the level of the scar.
case_images: CRIM2020-7635801.001.jpg
case_images: PMC7315276_01_CRIM2020-7635801.001.jpg
case_images: fig1
case_images: The abdomen bulged outward from the level of the lower sternum to below the umbilical fossa (Figure 1), and a 15 cm separation of rectus abdominis was palpated both above and below the umbilical fossa.
case_images: Preoperative abdominal computed tomography: (a) 3 cm above the superior border of the umbilicus; (b) center of the umbilicus; (c) 2 cm below the inferior border of the umbilicus. The inter-rectus distance is indicated by a white line.
case_images: CRIM2020-7635801.002.jpg
case_images: PMC7315276_01_CRIM2020-7635801.002.jpg
case_images: fig2
case_images: The inter-recti distance (IRD) was 36 mm at 3 cm above the superior border of the umbilicus, 40 mm at the center of the umbilicus, and 36 mm at 2 cm below the inferior border of the umbilicus (Figure 2).
case_images: Intraoperative photographs. (a) The rectus abdominis muscle is displaced to the left and right. The peritoneum is intact. (b) The anterior rectus muscle is sutured. (c) A mesh is applied to the rectus abdominal muscle. (d) Excess skin is removed in a spindle shape. (e) Closure of the incision.
case_images: CRIM2020-7635801.003.jpg
case_images: PMC7315276_01_CRIM2020-7635801.003.jpg
case_images: fig3
case_images: A spindle-shaped incision was used to excise this tissue, with the spindle measuring 15 cm in the horizontal direction (Figure 3).
case_images: (a-c) Postoperative abdominal computed tomography. (a) 3 cm above the superior border of the umbilicus; (b) center of the umbilicus; (c) 2 cm below the inferior border of the umbilicus. There is no apparent recurrence of the hernia. (d-e) Appearance three months after surgery. The patient's abdominal bulge has resolved.
case_images: CRIM2020-7635801.004.jpg
case_images: PMC7315276_01_CRIM2020-7635801.004.jpg
case_images: fig4
case_images: The patient is satisfied with her abdominal appearance (Figure 4).