title: Partial herniation through the peritoneal defect of a pfannenstiel incision: a rare complication of non-closure.
abstract: BACKGROUND
  The Pfannenstiel incision is used almost invariably in Caesarean section. With Caesarean section rates increasing, the Pfannenstiel is a commonly performed incision. The prevailing recommendation is not to close the peritoneum when closing a Pfannenstiel incision, and peritoneal non-closure does not appear to statistically influence postoperative complication rates.
  
  
  METHODS
  A 33-year-old woman presented with severe, intermittent lower abdominal pain one year after a Caesarean section. Laparoscopy showed a hernial defect at the Pfannenstiel incision, between the left rectus abdominis muscle and the anterior rectus sheath. Mesh repair was performed with uncomplicated postoperative outcome.
  
  
  CONCLUSIONS
  The current case illustrates that complications specific to non-closure of the peritoneum do arise. We advocate that laparoscopy should be considered for any patient with persistent, severe, or atypical pain following a Pfannenstiel incision.
authors.affiliation: Department of Colorectal Surgery, St James's Hospital, Dublin, Ireland.
authors.forename: John O
authors.initials: JO
authors.lastname: Larkin
authors.affiliation: Department of Colorectal Surgery, St James's Hospital, Dublin, Ireland.
authors.forename: Faisal N
authors.initials: FN
authors.lastname: Awan
authors.affiliation: Department of Colorectal Surgery, St James's Hospital, Dublin, Ireland.
authors.forename: Adrian C
authors.initials: AC
authors.lastname: McArdle
authors.affiliation: Department of Colorectal Surgery, St James's Hospital, Dublin, Ireland.
authors.forename: Paul H
authors.initials: PH
authors.lastname: McCormick
authors.affiliation: Department of Colorectal Surgery, St James's Hospital, Dublin, Ireland.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Mehigan
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D005260:Female; D046449:Hernia, Abdominal / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications / Q000601:surgery; D017568:Rectus Abdominis