Case report and operative management of obstructed epigastric hernia containing gall bladder: a rare entity

Abstract

An obstructed epigastric hernia containing gall bladder is a very rare entity and there are only few cases described in literature previously. A 69 year old woman presented at the emergency department at 1.00 a.m. with complains of pain and swelling in upper abdomen and having recurrent vomiting. As patient was sick and there was no imaging facility available at that time, patient was taken to OT in view of obstructed epigastric hernia. When abdomen was opened hernia sac containing gall bladder was seen. Then cholecystectomy and repair of the abdominal wall defect were performed. The patient recovered very well and was discharged on day 7.

Gallbladder Position Anomalies: Clinical Impacts and Management

“…In type 4, poor gallbladder mesenteric attachment may occur, as in cases of liver atrophy or cirrhosis, peritoneal fat loss secondary to aging, and weight loss [7,13,20,21]. These abnormal attachments predispose the gallbladder to torsion, herniation, strangulation, and increased stone formation [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

“…Kim et al [5] reviewed fourteen cases and reported only four cases of gallbladder herniation with GBV; the remaining ten cases had gallbladder herniation with acute cholecystitis. Floating gallbladder may herniate into anterior abdominal wall defects [25,[27][28][29][30][31][32], most commonly parastomal gallbladder herniation [29]. Unusual gallbladder herniations are also reported in the literature.…”

“…Female gender and old age are sole risk factors. The complications of gallbladder herniation include gallbladder torsion, cholecystitis, Mirizzi syndrome, incarceration, and ischemia [27][28][29][30][31][32]43].…”