Symptomatic Abdominal Wall Hernia

  • Goran Augustin


A hernia is an area of weakness or complete disruption of the fibromuscular tissues of the body wall. Abdominal wall hernias are not common during pregnancy because these are commonly repaired before a planned pregnancy to avoid possible complications during gestation. Hernias can be symptomless or have minimal symptoms, including slight discomfort or pain. Such hernias are not life-threatening and should be controlled on regular basis during pregnancy. Conservative measures should include weight control, the avoidance of heavy lifting, stool softeners, and abdominal binders. After spontaneous delivery and uterine involution, hernias should be repaired on an elective basis. It is of utmost importance for a clinician to diagnose emergent situations, which include incarceration, strangulation, and bowel perforation caused by a hernia because consultation with a surgeon and emergency operation are mandatory. There is still no consensus for an irreducible hernia during pregnancy, but complications during pregnancy outweigh semi-elective operation. (Incarcerated) gravid uterus in a hernia poses a specific problem because there is a higher risk of fetal death or obstetric complications. In this situation, operative treatment is almost a rule, which includes simultaneous obstetric and surgical management.


  1. 1.
    Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362:1561–71.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Primatesta P, Goldacre M. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996;25:835–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Nilsson H, Stylianidis G, Haapamäki M, et al. Mortality after groin hernia surgery. Ann Surg. 2007;245:656–60.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Carilli S. Hernia repair during Cesarean section. Int J Clin Med. 2015;6:1–6.CrossRefGoogle Scholar
  5. 5.
    Ochsenbein-Kölble N, Demartines NO, Imhof N, et al. Cesarean section and simultaneous hernia repair. Arch Surg. 2004;139:893–5.CrossRefPubMedGoogle Scholar
  6. 6.
    Robinson S. Hernia complicating pregnancy. Can Med Assoc J. 1954;68:592–3.Google Scholar
  7. 7.
    Berkeley C, Bonney V, MacLeod D, editors. The abnormal in obstetrics. London: Arnold; 1938.Google Scholar
  8. 8.
    Gaudier. Rev Chir. 1894;14:859.Google Scholar
  9. 9.
    Kahriman G, Donmez H, Mavili E, et al. Bilateral round ligament varicosities mimicking an inguinal hernia in pregnancy: case report. J Clin Ultrasound. 2010;38:512–4.CrossRefPubMedGoogle Scholar
  10. 10.
    McKenna DA, Carter JT, Poder L, et al. Round ligament varices: sonographic appearance in pregnancy. Ultrasound Obstet Gynecol. 2008;31:355–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Uzun M, Akkan K, Coşkun B. Round ligament varicosities mimicking inguinal hernias in pregnancy: importance of color doppler sonography. Diagn Interv Radiol. 2010;16:150–2.PubMedGoogle Scholar
  12. 12.
    FF Ijpma, Boddeus KM, de Haan HH, et al. Bilateral round ligament varicosities mimicking inguinal hernia during pregnancy. Hernia. 2009;13:85–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Chi C, Taylor A, Munjuluri N, et al. A diagnostic dilemma: round ligament varicosities in pregnancy. Acta Obstet Gynecol Scand. 2005;84:1126–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Cheng D, Lam H, Lam C. Round ligament varices in pregnancy mimicking inguinal hernia: an ultrasound diagnosis. Ultrasound Obstet Gynecol. 1997;9:198–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Smith P, Heimer G, Norgren A, et al. The round ligament: a target organ for steroid hormones. Gynecol Endocrinol. 1993;7:97–100.CrossRefPubMedGoogle Scholar
  16. 16.
    Jamader DA, Jacobson JA, Morag Y, et al. Sonography of inguinal region hernias. Am J Radiol. 2006;187:185–90.Google Scholar
  17. 17.
    Verovitz C, editor. Diseases of the veins and lymphatics of the lower extremity. Boston: Christopher Publishing House; 1941.Google Scholar
  18. 18.
    Jung JA, Son GH, Lee M, et al. A case of round ligament varicosities during pregnancy. Korean J Obstet Gynecol. 2010;53:180–3.CrossRefGoogle Scholar
  19. 19.
    Morton MJ, Paul MS, Metcalfe J. Exercise during pregnancy. Med Clin North Am. 1985;69:97–108.CrossRefPubMedGoogle Scholar
  20. 20.
    Lee DK, Bae SW, Moon H, et al. Round ligament varicosities mimicking inguinal hernia in pregnancy. J Korean Surg Soc. 2011;80:437–9.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Al-Qudah M. Postpartum pain due to thrombosed varicose veins of the round ligament of the uterus. Postgrad Med J. 1993;69:820–1.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Frede T. Ultrasonic visualization of varicosities in the female genital tract. J Ultrasound Med. 1984;3:365–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Buxton N, Boulougouris P, Pai K, et al. Immediate post partum thrombosis of the veins of the round ligament imitating an irreducible inguinal hernia. Acta Obstet Gynecol Scand. 1994;73:514–5.CrossRefPubMedGoogle Scholar
  24. 24.
  25. 25.
    Candiani GB, Vercellini P, Fedele L, et al. Inguinal endometriosis: pathogenetic and clinical implications. Obstet Gynecol. 1991;78:191–4.PubMedGoogle Scholar
  26. 26.
    Goh JTW, Flynn V. Inguinal endometriosis. Aust N Z J Obstet Gynaecol. 1994;34:121.CrossRefPubMedGoogle Scholar
  27. 27.
    Sun ZJ, Zhu L, Lang J. A rare extrapelvic endometriosis: inguinal endometriosis. J Reprod Med. 2010;55:62–6.PubMedGoogle Scholar
  28. 28.
    Jimenez M, Miles R. Inguinal endometriosis. Ann Surg. 1960;151:903–11.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Freed KS, Granke DS, Tyre L, et al. Endometriosis of the extraperitoneal portion of the round. ligament: US and CT findings. J Clin Ultrasound. 1996;24:540–2.CrossRefPubMedGoogle Scholar
  30. 30.
    Wong WSF, Lim CED, Luo X. Inguinal endometriosis: an uncommon differential diagnosis as an inguinal tumour. ISRN Obstet Gynecol. 2011;2011:272159.PubMedGoogle Scholar
  31. 31.
    Cullen T. Adenomyoma of the round ligament. Johns Hopkins Hosp Bull. 1896;7:112–4.Google Scholar
  32. 32.
    Crispi CP, de Souza CA, Oliveira M, et al. Endometriosis of the round ligament of the uterus. J Minim Invasive Gynecol. 2012;19:46–51.CrossRefPubMedGoogle Scholar
  33. 33.
    Park SJ, Lee HK, Hong H, et al. Hydrocele of the canal of Nuck in a girl: ultrasound and MR appearance. Br J Radiol. 2004;77:243–4.CrossRefPubMedGoogle Scholar
  34. 34.
    Yang DM, Kim HC, Ryu J, et al. Sonographic findings of inguinal endometriosis. J Ultrasound Med. 2010;29:105–10.CrossRefPubMedGoogle Scholar
  35. 35.
    Cervini P, Mahoney J, Wu L. Endometriosis in the canal of Nuck: atypical manifestations in an unusual location. Am J Roentgenol. 2005;185:284–5.CrossRefGoogle Scholar
  36. 36.
    Chalouhi GE, Harb CA, Atallah DM, et al. Extraperitoneal endometriosis as a differential diagnosis of an inguinal lump. Eur J Obstet Gyncol Reprod Biol. 2008;138:121–2.CrossRefGoogle Scholar
  37. 37.
    Yang DM, Kim HC, Jin W, et al. Inguinal endometriosis presenting as a multicystic mass on sonography. J Ultrasound Med. 2007;26:1449–51.CrossRefPubMedGoogle Scholar
  38. 38.
    Hensen JH, Van Breda Vriesman AC, Puylaert J. Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. Am J Roentgenol. 2006;186:616–20.CrossRefGoogle Scholar
  39. 39.
    Low RS, Jones AO, Houang M, et al. Endometriosis of the inguinal region: Magnetic Resonance Imaging (MRI) findings. Australas Radiol. 2007;51:B272–5.CrossRefPubMedGoogle Scholar
  40. 40.
    Hagiwara Y, Hatory M, Moriya T, et al. Inguinal endometriosis attaching to the round ligament. Australas Radiol. 2007;51:91–4.CrossRefPubMedGoogle Scholar
  41. 41.
    Toprak H, Kiliç E, Kocakoç E, et al. Ultrasound and Doppler US in evaluation of superficial soft-tissue lesions. J Clin Imaging Sci. 2014;4:12.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Ku JKK, Marfan M, O’Shea M, et al. Differential diagnosis of an incarcerated inguinal hernia: extraperitoneal endometrioma of the round ligament. Gd Rounds. 2006;6:18–21.Google Scholar
  43. 43.
    Fedele L, Bianchi S, Frontino G, et al. Radical excision of inguinal endometriosis. Obstet Gynecol. 2007;110:530–3.CrossRefPubMedGoogle Scholar
  44. 44.
    Seydel AS, Sickel JZ, Warner ED, et al. Extrapelvic endometriosis: diagnosis and treatment. Am J Surg. 1996;171:239–41.CrossRefPubMedGoogle Scholar
  45. 45.
    Horton JD, Dezee KJ, Ahnfeldt EP, et al. Abdominal wall endometriosis: a surgeon’s perspective and review of 445 cases. Am J Surg. 2008;196:207–12.CrossRefGoogle Scholar
  46. 46.
    Scholefield HJ, Sajjad Y, Morgan P. Cutaneous endometriosis and its association with caesarean section and gynaecological procedures. J Obstet Gynaecol. 2002;22:553–4.CrossRefPubMedGoogle Scholar
  47. 47.
    Anderson CC, Broadie TA, Mackey JK, et al. Hydrocele of the canal of Nuck: ultrasound appearance. Am Surg. 1995;61:959–61.PubMedGoogle Scholar
  48. 48.
    Schwartz A, Peyser M. Nuck’s hydrocele. Int Surg. 1975;60:91–2.PubMedGoogle Scholar
  49. 49.
    Block R. Hydrocele of the canal of Nuck; a report of five cases. Obstet Gynecol. 1975;4:464–6.Google Scholar
  50. 50.
    Alam A, Nice C, Uberoi R. The accuracy of ultrasound in the diagnosis of clinically occult groin hernias in adults. Eur Radiol. 2005;15:2457–61.CrossRefPubMedGoogle Scholar
  51. 51.
    Buch KE, Tabrizian P, Divino C. Management of hernias in pregnancy. J Am Coll Surg. 2008;207:539–42.CrossRefPubMedGoogle Scholar
  52. 52.
    Koch A, Edwards A, Haapaniemi S, et al. Prospective evaluation of 6895 groin hernia repairs in women. Br J Surg. 2005;92:1553–8.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Nordin P, Hernell H, Unosson M, et al. Type of anaesthesia and patient acceptance in groin hernia repair: a multicentre randomised trial. Hernia. 2004;8:220–5.CrossRefGoogle Scholar
  54. 54.
    Ferguson A. Indications for operation. In:The technic of modern operations for hernia. 2nd ed. Chicago: Cleveland Press; 1908. p. 58–72.Google Scholar
  55. 55.
    Tagaya N, Kasama K, Suzuki N, et al. Simultaneous laparoscopic treatment for diseases of the gallbladder, stomach, and colon. Surg Laparosc Endosc Percutan Tech. 2005;15:169–71.CrossRefPubMedGoogle Scholar
  56. 56.
    Othman I, Abdel-Maguid A. Combined transurethral prostatectomy and inguinal hernioplasty. Hernia. 2005;14:149–53.CrossRefGoogle Scholar
  57. 57.
    Altchek A, Rudick J. Preperitoneal herniorrhaphy: adjunct to cesarean section. Obstet Gynecol. 1987;70:470–1.PubMedGoogle Scholar
  58. 58.
    Ghnnam WM, Helal AS, Fawzy M, et al. Paraumbilical hernia repair during cesarean delivery. Ann Saudi Med. 2009;29:115–8.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Simchen E, Wax Y, Galai N, et al. Differential effect of risk factors on early and late wound infections in patients undergoing herniorrhaphies. Ann Epidemiol. 1992;2:263–72.CrossRefPubMedGoogle Scholar
  60. 60.
    Gabriele R, Conte M, Izzo L, et al. Cesarean section and hernia repair: simultaneous approach. J Obstet Gynaecol Res. 2010;36:944–9.CrossRefPubMedGoogle Scholar
  61. 61.
    Nyhus L. Iliopubic tract repair of inguinal and femoral hernia. The posterior (preperitoneal) approach. Surg Clin North Am. 1993;73:487–99.CrossRefPubMedGoogle Scholar
  62. 62.
    Janu PG, Sellers KD, Mangiante E. Recurrent inguinal hernia: preferred operative approach. Am Surg. 1998;64:569–74.PubMedGoogle Scholar
  63. 63.
    McEntee G, Pender D, Mulvin D, et al. Current spectrum of intestinal obstruction. Br J Surg. 1987;74:976–80.CrossRefPubMedGoogle Scholar
  64. 64.
    Gilbert AI, Felton L. Infection in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet. 1993;177:126–30.PubMedGoogle Scholar
  65. 65.
    Earle DB, McLellan JA. Repair of umbilical and epigastric hernias. Surg Clin North Am. 2013;93:1057–89.CrossRefPubMedGoogle Scholar
  66. 66.
    Jackson OJ, Moglen L. Umbilical hernia. A retrospective study. Calif Med. 1970;113:8–11.PubMedPubMedCentralGoogle Scholar
  67. 67.
    Meier DE, OlaOlorun DA, Omodele R, et al. Incidence of umbilical hernia in African children: redefinition of “normal” and reevaluation of indications for repair. World J Surg. 2001;25:645–8.CrossRefPubMedGoogle Scholar
  68. 68.
    Thomson S. Two unusual complications of umbilical hernia in pregnancy. BMJ. 1962;2:1586.CrossRefPubMedGoogle Scholar
  69. 69.
    Robinson E. Ventral hernia during pregnancy. JAMA. 1907;48:226.CrossRefGoogle Scholar
  70. 70.
    Coley WB, Hoguet J. Operative treatment of hernia: a consideration of 8589 cases of hernia treated by radical operation from 1891 to 1918, with special reference to methods of operating and end results. Ann Surg. 1918;68:255–68.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
  72. 72.
    Uludag M, Yetkin G, Demirel M, et al. Incarceration of umbilical hernia during pregnancy due to a sessile fibroid. Hernia. 2006;10:357–9.CrossRefPubMedGoogle Scholar
  73. 73.
    Rao RS, Shankaregowda H. A case of herniated gravid uterus through a laparotomy scar. Indian J Med Sci. 2006;60:154–7.CrossRefPubMedGoogle Scholar
  74. 74.
    Bajekal N, Li T. Fibroids, infertility and pregnancy wastage. Hum Reprod Update. 2000;6:614–20.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Hassim AM, Khurana K. Gravid uterus in an umbilical hernia. Cent Afr J Med. 1967;13:260–1.PubMedGoogle Scholar
  76. 76.
    Punguyire D, Iserson KV, Apanga S. Full-term pregnancy in umbilical hernia. Pan Afr Med J. 2011;8Google Scholar
  77. 77.
    Van Rooyen AJ, Cominos DC, van der Walt A. Pressure necrosis of a caesarean section scar with exteriorization of the gravid uterus. S Afr Med J. 1977;51:666–8.PubMedGoogle Scholar
  78. 78.
    Ahmed A, Stephen G, Ukwenya Y. Spontaneous rupture of umbilical hernia in pregnancy: a case report. Oman Med J. 2011;26:285–7.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Douglas C, Rotimi O. Extragenital endometriosis – a clinicopathological review of Glasgow hospital experience with case illustrations. J Obstet Gynaecol. 2004;24:804–8.CrossRefPubMedGoogle Scholar
  80. 80.
    Fernández-Aceñero MJ, Córdova S. Cutaneous endometriosis: review of 15 cases diagnosed at a single institution. Arch Gynecol Obstet. 2011;283:1041–4.CrossRefPubMedGoogle Scholar
  81. 81.
    Agarwal A, Fong Y. Cutaneous endometriosis. Singap Med J. 2008;49:704–9.Google Scholar
  82. 82.
    Wiegratz I, Kissler S, Engels K, et al. Umbilical endometriosis in pregnancy without previous surgery. Fertil Steril. 2008;90:199.e17–20.CrossRefGoogle Scholar
  83. 83.
    Razzi S, Rubegni P, Sartini A, et al. Umbilical endometriosis in pregnancy: a case report. Gynecol Endocrinol. 2004;18:114–6.CrossRefPubMedGoogle Scholar
  84. 84.
    Fedele L, Frontino G, Biachi S, et al. Umbilical endometriosis: a radical excision with laparoscopic assistance. Int J Surg. 2010;8:109–11.CrossRefPubMedGoogle Scholar
  85. 85.
    Weller C. Endometriosis of the umbilicus. Am J Pathol. 1935;11:281–6.PubMedPubMedCentralGoogle Scholar
  86. 86.
    Hartigan CM, Holloway B. MR imaging features of endometriosis at the umbilicus. Br J Radiol. 2005;78:755–7.CrossRefPubMedGoogle Scholar
  87. 87.
    Victory R, Diamond MP, Johns D. Villar’s nodule: a case report and systematic literature review of endometriosis externa of the umbilicus. J Minim Invasive Gynecol. 2007;14:23–32.CrossRefPubMedGoogle Scholar
  88. 88.
    Mintz W. Das Nabeladenom. Arch F Klin Chir. 1909;89:385–8.Google Scholar
  89. 89.
    Ramsanahie A, Giri SK, Velusamy S, et al. Endometriosis in a scarless abdominal wall with underlying umbilical hernia. Ir J Med Sci. 2000;169:67.CrossRefPubMedGoogle Scholar
  90. 90.
    Kyamidis K, Lora V, Kanitakis J. Spontaneous cutaneous umbilical endometriosis: Report of a new case with immunohistochemical study and literature review. Dermatol Online J. 2011;17:5.PubMedGoogle Scholar
  91. 91.
    Di Giorgi V, Massi D, Mannone F, et al. Cutaneous endometriosis: non-invasive analysis by epiluminescence microscopy. Clin Exp Dermatol. 2003;28:315–7.CrossRefPubMedGoogle Scholar
  92. 92.
    Bagade PV, Guirguis M. Menstruating from the umbilicus as a rare case of primary umbilical endometriosis: a case report. J Med Case Rep. 2009;3:9326.CrossRefPubMedPubMedCentralGoogle Scholar
  93. 93.
    Giudice LC, Kao L. Endometriosis. Lancet. 2004;364:1789–99.CrossRefGoogle Scholar
  94. 94.
    Chatzikokkinou P, Thorfin J, Angelidis I, et al. Spontaneous endometriosis in an umbilical skin lesion. Acta Dermatovenerol Alp Panon Adriat. 2009;18:126–30.Google Scholar
  95. 95.
    Heaps JM, Nieberg RK, Berek J. Malignant neoplasms arising in endometriosis. Obstet Gynecol. 1990;75:1023–8.PubMedGoogle Scholar
  96. 96.
    Sampson J. Postsalpingectomy endometriosis (endosalpingiosis). Am J Obstet Gynecol. 1930;20:443–80.CrossRefGoogle Scholar
  97. 97.
    Sinkre P, Hoang MP, Albores-Saavedra J. Mullerianosis of inguinal lymph nodes: report of a case. Int J Gynecol Pathol. 2002;21:60–4.CrossRefPubMedGoogle Scholar
  98. 98.
    Redondo P, Idoate M, Corella C. Cutaneous umbilical endosalpingiosis with severe abdominal pain. J Eur Acad Dermatol Venereol. 2001;15:179–80.CrossRefPubMedGoogle Scholar
  99. 99.
    Papavramidis TS, Sapalidis K, Michalopoulos N, et al. Umbilical endosalpingiosis: a case report. J Med Case Rep. 2010;4:287.CrossRefPubMedPubMedCentralGoogle Scholar
  100. 100.
    Sherman SC, Lee L. Strangulated umbilical hernia. J Emerg Med. 2004;26:209–11.CrossRefPubMedGoogle Scholar
  101. 101.
  102. 102.
    Singla SL, Kalra U, Singh B, et al. Ruptured incisional hernia. Trop Dr. 1997;27:112–3.Google Scholar
  103. 103.
    Meen E, Vergis A. Rare cause of an inguinal mass in pregnancy. Can J Surg. 2008;51:E124.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Wydell S. Umbilical hernia in pregnancy. BMJ. 1963;1:1413–4.CrossRefPubMedGoogle Scholar
  105. 105.
    Debrah SA, Okpala A. Epigastric hernia in pregnancy: a management plan based on a systematic review of literature and a case history. Indian J Surg. 2013;75:212–3.CrossRefPubMedGoogle Scholar
  106. 106.
    Schoenmaeckers E, Stirler V, Raymakers J, et al. Pregnancy following laparoscopic mesh repair of ventral abdominal wall hernia. JSLS. 2012;16:85–8.CrossRefPubMedPubMedCentralGoogle Scholar
  107. 107.
    Dare FO, Makinde OO, Lawal O. Gravid uterus in an anterior abdominal wall hernia of a Nigerian woman. Int J Gynaecol Obstet. 1999;32:377–9.CrossRefGoogle Scholar
  108. 108.
    Fullman P. An incisional hernia containing an incarcerated twin pregnant uterus. Am J Obstet Gynecol. 1971;111:308–9.CrossRefPubMedGoogle Scholar
  109. 109.
    Banerjee N, Deka D, Sinha A, et al. Gravid uterus in an incisional hernia. J Obstet Gynaecol Res. 2001;27:77–9.CrossRefPubMedGoogle Scholar
  110. 110.
    Holmes A. Case of hernia of the gravid uterus. Trans R Acad Med Irel. 1906;24:312–4.CrossRefGoogle Scholar
  111. 111.
    Boys C. Strangulated hernia containing pregnant uterus at term. Am J Obstet Gynecol. 1945;50:450–2.CrossRefGoogle Scholar
  112. 112.
    Makama JG, Odigie VI, Yusufu L, et al. Herniated gravid uterus: clinical course and result of treatment. Ann Afr Med. 2007;6:197–9.CrossRefPubMedGoogle Scholar
  113. 113.
    Sahul A, Bupathy A. Evisceration of pregnant uterus through incisional hernia site. J Obstet Gynaecol Res. 2006;32:338–40.CrossRefGoogle Scholar
  114. 114.
    Ray KK, Aggarwal S, Banerjee K, et al. Gravid uterus in an incisional hernia leading to burst abdomen. Int J Gynecol Obstet. 2005;5:2–5.Google Scholar
  115. 115.
    Nagpal M, Kaur S. Herniated pregnant uterus with bleeding from previous abdominal scar. J Obstet Gynaecol India. 2003;53:283.Google Scholar
  116. 116.
    Rathi, N; Gupta A Term uterus in complicated ventral hernia J Postgrad Gynecol Obstet. 2014;1.Google Scholar
  117. 117.
    Malhotra M, Sharma JB, Wadhwa L, et al. Successful pregnancy outcome after cesarean section in a case of gravid uterus growing in an incisional hernia of the anterior abdominal wall. Indian J Med Sci. 2003;57:501–3.PubMedGoogle Scholar
  118. 118.
    Deka D, Banerjee N, Takkar D. Incarcerated pregnant uterus in an incisional hernia. Int J Gynecol Obstet. 2000;70:377–9.CrossRefGoogle Scholar
  119. 119.
    Wolfe WR, Egley CC, Saad EJ, et al. Prefascial marsupialization of the pregnant uterus. Obstet Gynecol. 1988;71:1021–3.PubMedGoogle Scholar
  120. 120.
    Saha PK, Rohilla M, Prasad G, et al. Herniation of gravid uterus: report of 2 cases and review of literature. Med Gen Med. 2006;8:14.Google Scholar
  121. 121.
    Abasiattai AM, Umoiyoho AJ, Utuk NM, et al. Gravid uterus in an anterior abdominal wall hernia: report of two cases and review of literature. Anatol J Obstet Gynecol. 2012;1:3.Google Scholar
  122. 122.
    Cahalane MJ, Shapiro ME, Silen W. Abdominal incision: decision or indecision? Lancet. 1989;1:146–8.CrossRefPubMedGoogle Scholar
  123. 123.
    Singh KK, Lessells AM, Adam D, et al. Presentation of endometriosis to general surgeons: a 10-year experience. Br J Surg. 1995;82:1349–51.CrossRefPubMedGoogle Scholar
  124. 124.
    Dwivedi AJ, Agrawal SN, Silva Y. Abdominal wall endometriomas. Dig Dis Sci. 2002;47:456–61.CrossRefPubMedGoogle Scholar
  125. 125.
    Wolf GC, Singh K. Cesarean scar endometriosis: a review. Obstet Gynecol Surv. 1989;44:89–95.CrossRefPubMedGoogle Scholar
  126. 126.
    Chatterjee S. Scar endometriosis: a clinicopathologic study of 17 cases. Obstet Gynecol. 1980;56:81–4.PubMedGoogle Scholar
  127. 127.
    Rani PR, Soundararaghavan S, Rajaram P. Endometriosis in abdominal scars - review of 27 cases. Int J Gynaecol Obstet. 1991;36:215–8.CrossRefPubMedGoogle Scholar
  128. 128.
    Misra R, Bajaj SK, Khatri GD, et al. Gravid uterus in post caesarean incisional hernia: a rare occurrence. Int J Reprod Contracept Obstet Gynecol. 2015;4:286–8.Google Scholar
  129. 129.
    Uchenna EG, Chukwuneme OB, Ejike E, et al. Herniated near-term pregnancy through an incisional hernia treated with polypropylene mesh: a case report. Niger Med J. 2014;55:271–3.CrossRefPubMedPubMedCentralGoogle Scholar
  130. 130.
    Blanco RG, Parithivel VS, Shah A, et al. Abdominal wall endometriomas. Am J Surg. 2003;185:596–8.CrossRefPubMedGoogle Scholar
  131. 131.
    Patterson GK, Winburn G. Abdominal wall endometriomas: report of eight cases. Am Surg. 1999;65:36–9.PubMedGoogle Scholar
  132. 132.
    Steck WD, Helwig E. Cutaneous endometriosis. Clin Obstet Gynecol. 1966;9:373–83.CrossRefGoogle Scholar
  133. 133.
    Nirula R, Greaney G. Incisional endometriosis: an underappreciated diagnosis in general surgery. J Am Coll Surg. 2000;190:404–7.CrossRefPubMedGoogle Scholar
  134. 134.
    Coley BD, Casola G. Incisional endometrioma involving the rectus abdominis muscle and subcutaneous tissues: CT appearance. Am J Roentgenol. 1993;160:549–50.CrossRefGoogle Scholar
  135. 135.
    Balleyguier C, Chapron C, Chopin N, et al. Abdominal wall and surgical scar endometriosis: results of magnetic resonance imaging. Gynecol Obstet Investig. 2003;55:220.CrossRefGoogle Scholar
  136. 136.
    Bektaş H, Bilsel Y, Sari Y, et al. Abdominal wall endometrioma; a 10-year experience and brief review of the literature. J Surg Res. 2010;164:e77–81.CrossRefPubMedGoogle Scholar
  137. 137.
    Busard MP, Mijatovic V, van Kuijk C, et al. Appearance of abdominal wall endometriosis on MR imaging. Eur Radiol. 2010;20:1267–76.CrossRefPubMedGoogle Scholar
  138. 138.
    Jenkins T. The burst abdominal wound: a mechanical approach. Br J Surg. 1976;63:873–6.CrossRefGoogle Scholar
  139. 139.
    Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. BMJ. 1982;284:931–3.CrossRefPubMedGoogle Scholar
  140. 140.
    Abrahamson J, Gorman J. Pregnancy and ventral hernia repair. Hernia. 2000;4:187–91.CrossRefGoogle Scholar
  141. 141.
    Dare O, Lawal O. Experience with 29 cases of female ventral incisional hernia in Ile Ife, Nigeria. Int J Gynaecol Obstet. 1991;36:29–32.CrossRefPubMedGoogle Scholar
  142. 142.
    Ramirez OM, Ruas E, Dellon A. “Components separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990;86:519–26.CrossRefPubMedPubMedCentralGoogle Scholar
  143. 143.
    Palazzo F, Ragazzi S, Ferrara D, et al. Herniated gravid uterus through an incisional hernia treated with the component separation technique. Hernia. 2010;14:101–4.CrossRefPubMedGoogle Scholar
  144. 144.
    Wai PY, Ruby JA, Davis K, et al. Laparoscopic ventral hernia repair during pregnancy. Hernia. 2009;13:559–63.CrossRefPubMedGoogle Scholar
  145. 145.
    Kim WB, Kim J, Boo Y, et al. Successful vaginal delivery following laparoscopic abdominal reconstruction in an adult survivor of an omphalocele without prior surgical repair: report of a case. Hernia. 2009;13:431.CrossRefPubMedGoogle Scholar
  146. 146.
    Collins AM, Power KT, Gaughan B, et al. Abdominal wall reconstruction for a large caesarean scar endometrioma. Surgeon. 2009;7:252–3.CrossRefPubMedGoogle Scholar
  147. 147.
    Kaunitz A, Di Sant’Agnese P. Needle tract endometriosis: an unusual complication of amniocentesis. Obstet Gynecol. 1979;54:753–5.PubMedGoogle Scholar
  148. 148.
    Liang CC, Liou B, Tsai C, et al. Scar endometriosis. Int Surg. 1998;83:69–71.PubMedGoogle Scholar
  149. 149.
    Wang PH, Juang CM, Chao H, et al. Wound endometriosis: risk factor evaluation and treatment. J Chin Med Assoc. 2003;66:113.PubMedGoogle Scholar
  150. 150.
    Jenkins T. Incisional hernia repair: a mechanical approach. Br J Surg. 1980;67:335–6.CrossRefGoogle Scholar
  151. 151.
    Luijendijk RW, Hop WC, van den Tol M, et al. A comparison of suture repair with mesh repair for incisional hernia. New Engl J Med. 2000;343:392–8.CrossRefPubMedGoogle Scholar
  152. 152.
    Klinge U, Müller M, Brücker C, et al. Application of three dimensional stereography to assess abdominal wall mobility. Hernia. 1998;2:11–4.CrossRefGoogle Scholar
  153. 153.
    Junge K, Klinge U, Prescher A, et al. Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implants. Hernia. 2001;5:113–8.CrossRefPubMedGoogle Scholar
  154. 154.
    Mulder RJ, Stroobants WL, Roumen F. Pregnancy and delivery with an abdominal mesh graft. Eur J Obstet Gynecol Reprod Biol. 2004;116:235–6.CrossRefPubMedGoogle Scholar
  155. 155.
    Aaen V, Cowan L, Sakala EP, et al. Prolonged parenteral meperidine analgesia during pregnancy for pain from an abdominal wall mesh graft. Obstet Gynecol. 1993;82:721–2.PubMedGoogle Scholar
  156. 156.
    Wassenaar E, Schoenmaeckers E, Raymakers J, et al. Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair: a randomized trial of three fixation techniques. Surg Endosc. 2010;24:1296–302.CrossRefGoogle Scholar
  157. 157.
    Parastomal PR. hernias. World J Surg. 1989;13:569–72.CrossRefGoogle Scholar
  158. 158.
    Devlin H. Peristomal hernia. In: Dudley H, editor. Operative surgery volume 1: alimentary tract and abdominal wall. 4th ed. London: Butterworths; 1983. p. 441–3.Google Scholar
  159. 159.
    Van Horn C, Barrett P. Pregnancy, delivery, and postpartum experiences of fifty-four women with ostomies. J Wound Ostomy Cont Nurs. 1997;24:151–62.CrossRefGoogle Scholar
  160. 160.
    Cunningham FG, Leveno KJ, Bloom S, et al., editors. Williams ostetrics. 24th ed. New York: McGraw Hill; 2014.Google Scholar
  161. 161.
    Hudson C. Ileostomy in pregnancy. Proc R Soc Med. 1972;65:281–3.PubMedPubMedCentralGoogle Scholar
  162. 162.
    Carne PWG, Robertson GM, Frizelle F. Parastomal hernia. Br J Surg. 2003;90:784–93.CrossRefPubMedGoogle Scholar
  163. 163.
    Jänes A, Cengiz Y, Israelsson L. Preventing parastomal hernia with a prosthetic mesh. Arch Surg. 2004;139:1356–8.CrossRefPubMedGoogle Scholar
  164. 164.
    Steele SR, Lee P, Martin MJ, et al. Is parastomal hernia repair with polypropylene mesh safe? Am J Surg. 2003;185:436–40.CrossRefPubMedGoogle Scholar
  165. 165.
    Jänes A, Cengiz Y, Israelsson LA. Preventing parastomal hernia with a prosthetic mesh: a 5-Year follow-up of a randomized study. World J Surg. 2009;33:118–21.CrossRefPubMedGoogle Scholar
  166. 166.
    Abcarian H. Peristomal hernias. In: Wexner SD, Vernava A, editors. Clinical decision making in colorectal surgery. New York: Igaku-Shoin; 1995. p. 449–52.Google Scholar
  167. 167.
    Williams JG, Etherington R, Hayward MWJ, et al. Paraileostomy hernia: a clinical and radiological study. Br J Surg. 1990;77:1355–7.CrossRefPubMedGoogle Scholar
  168. 168.
    Barber HRK, Graber E. Hernias in pregnancy. In: Barber HRK, Graber E, editors. Surgical disease in pregnancy. Philadelphia: WB Saunders; 1974. p. 165–7.Google Scholar
  169. 169.
    Bani D. Relaxin: a pleiotropic hormone. Gen Pharmacol. 1997;28:13–22.CrossRefPubMedGoogle Scholar
  170. 170.
    Bay-Nielsen M, Kehlet H. Inguinal herniorrhaphy in women. Hernia. 2006;10:30–3.CrossRefGoogle Scholar
  171. 171.
    Axer H, Graf D, Keyserlingk MD, et al. Collagen fibers in linea alba and rectus sheaths. J Surg Res. 2001;96:127–34.CrossRefPubMedGoogle Scholar
  172. 172.
    Coldron Y, Stokes MJ, Newham DJ, et al. Postpartum characteristics of rectus abdominis on ultrasound imaging. Man Ther. 2008;13:112–21.CrossRefPubMedGoogle Scholar
  173. 173.
    Boissonnault JS, Blaschak M. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther. 1988;68:1082–6.CrossRefPubMedGoogle Scholar
  174. 174.
    Spitznagle TM, Leong FC, Van Dillen L. Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:321–8.CrossRefPubMedGoogle Scholar
  175. 175.
    Lee D, editor. The Pelvic Girdle. 4th ed. London: Churchill Livingstone; 2011.Google Scholar
  176. 176.
    Hungerford BA, Gilleard W, Moran M, et al. Evaluation of the ability of physical therapists to palpate intrapelvic motion with the Stork test on the support side. Phys Ther. 2007;87:879–87.CrossRefPubMedGoogle Scholar
  177. 177.
    Hungerford B, Gilleard W, Lee D. Altered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers. Clin Biomech (Bristol, Avon). 2004;19:456–64.CrossRefGoogle Scholar
  178. 178.
    Mens JM, Vleeming A, Snijders C, et al. The active straight leg raising test and mobility of the pelvic joints. Eur Spine J. 1999;8:468–73.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Goran Augustin
    • 1
    • 2
  1. 1.School of Medicine University of ZagrebZagrebCroatia
  2. 2.Department of SurgeryUniversity Hospital Centre ZagrebZagrebCroatia

Personalised recommendations