Gallbladder strangulation within a recurrent incisional hernia: An unique cause of acute cholecystitis

Abstract

We present a report of a unique surgical entity: acute cholecystitis caused by the gallbladder strangulation within a recurrent right upper quadrant incisional hernia. A previously healthy 39 year-old male patient presented to our Emergency Department with abdominal pain, nausea, vomiting, and a tender mass in the right upper quadrant of the abdomen, where an incisional hernia was palpable. He had a history of a gunshot wound to the right upper quadrant and multiple operations to include repairing mesh of the incisional hernia in that area. Abdominal computed tomography demonstrated an acutely inflamed gallbladder within the recurrent hernia. Open cholecystectomy and primary hernia repair were performed. Intraoperatively, the gallbladder appeared being strangled within the hernia. The patient recovered uneventfully and no cholelithiasis was observed on gross examination of the gallbladder. Though there have been a few reports of gallbladder strangulation within primary incisional hernia, ours is the first to describe this phenomenon in a recurrent hernia.