Rare delayed presentation of post-appendectomy incisional hernia: A case report

Incisional hernia is a considered late complication of abdominal surgery. Post-appendectomy incisional hernia is relatively uncommon. The present case presents 57years old female patient with sudden bulge over right iliac fossa 20 years post-appendectomy with severe pain in abdomen and nausea. Though the bulge reduced afterwords severe tenderness was present at right iliac fossa. Diagnosis of incisional hernia was made and open incisional hernioplasty with polypropylene mesh and negative suction drain placement was done. Post-operative recovery was satisfactory. This case highlights possibility of delayed and rare presentation of incisional hernia two decades after appendectomy even without the clinical bulge thus making it unique. Careful consideration of every probable diagnosis and correlating with previous surgical history is important in such cases. With reliable investigations and surgical expertise any challenging diagnosis can be managed successfully. In Ayurveda, Vruddhi is described in Sushruta Sanhita where out of 7 types hernia can be co-related with Antravruddhi.