Spontaneous ventral hernia through the rectus abdominis muscles: a case report

Abstract Background A hernia is a condition in which tissues or organs are abnormally protruding through a defect in the surrounding wall. We experienced a rare spontaneous ventral hernia that penetrated the right transverse abdominal fascia and rectus abdominis muscles. Case presentation A 92-year-old woman was admitted to our hospital with major complaints of right abdominal pain and some quadrant mass. She had no history of trauma and lower abdominal surgery. Computed tomography revealed that a protrusion of the hernia from the right lower abdominal wall. The hernia contents were small intestine, which penetrated the transverse abdominis fascia and rectus abdominis muscles. The herniation has been manually reduced. Elective surgery was performed 3 days later. The intraoperative findings indicated that the hernia sac was located around the middle of the rectus abdominis muscles in the right lower abdominal wall. Hernioplasty was performed using Bard Light PerFix Plug®. The patient fully recovered and was discharged 8 days after surgery. No recurrence was identified for 42 months during patient follow-up. Conclusions We presented a rare case of hernia, which was protruded through the rectus abdominis muscles. Intrinsic anatomical weakness of the abdominal wall and age-related muscle atrophy might have caused this rare hernia. This case report provides clinicians useful information for accurate diagnosis and successful treatments of this type of hernia in the elderly, and contributes to identifying the anatomical features of some rare ventral hernias.