Inside-out: Spontaneous bowel evisceration, a rare complication of the ventral hernia

Abstract

Spontaneous nontraumatic bowel evisceration from a ruptured long-standing abdominal wall hernia is a rare occurrence. Sporadic case reports exist describing bowel evisceration from long-standing ventral herniae, whereby baseline increased intra-abdominal pressure was rendered more pronounced due to sudden increase and/or trauma. Morbidity and mortality rates are significant, and treatment can be technically complex. We present a case of spontaneous small bowel evisceration from rupture of a recurrent ventral hernia in a patient with liver cirrhosis, who was managed with emergent surgical mesh repair and discuss the spectrum of relevant surgical techniques for this unique group of patients.

Keywords

• biological mesh
• complex ventral hernia
• mesh repair
• spontaneous bowel evisceration