title: Unusual hernia in a colostomy closure site.
abstract: This is a case report of an interstitial hernia following previous transverse loop colostomy closure. There are no reported cases in the literature of gangrenous gall-bladder as the content of an interstitial hernia. This condition can present as a diagnostic challenge. We present a case with a previous reversal of a colostomy in the right upper quadrant presenting with a short history of a right iliac fossa mass and tenderness. Clinically, the patient was septic without any peritonitis. Subsequent computed tomography scan suggested the hernial sac contained gall-bladder and loops of bowel. At surgery, a gangrenous gall-bladder was found within an interstitial incisional hernia (between the external and internal oblique muscle). Retrograde cholecystectomy was performed and bowel and hernia were reduced. The hernia was repaired in layers and patient had an uneventful recovery.
authors.affiliation: Department of Surgery, Maidstone & Tunbridge Wells Hospitals NHS Trust, Maidstone, Kent, UK. m.howlader@ucl.ac.uk
authors.forename: Mohammad
authors.initials: M
authors.lastname: Howlader
authors.forename: Thishi
authors.initials: T
authors.lastname: Surendranathan
authors.forename: Yasser
authors.initials: Y
authors.lastname: Abdulaal
authors.forename: Alan
authors.initials: A
authors.lastname: James
authors.forename: Haythem
authors.initials: H
authors.lastname: Ali
authors.forename: Amir
authors.initials: A
authors.lastname: Nisar