反复发作巨大切口疝合并腹壁脓肿一例

Recurrent Giant Incisional Hernia Complicated by an Abdominal Wall Abscess: A Case Report

摘要: 切口疝是腹部外科手术常见的手术并发症。而巨大切口疝因腹壁组织缺损严重、生物力学稳定性差，修复难度显著增加。当合并腹壁脓肿时，感染与缺损相互促进，形成“感染–组织破坏–疝复发–感染加重”的恶性循环。本文报道1例57岁女性巨大切口疝合并腹壁脓肿反复发作病例，患者既往有腹腔镜中转开腹肝胆手术史，先后四次住院接受补片修补、脓肿引流、补片取出及生物补片修复等治疗。通过详细分析其临床表现、影像学特征、手术策略演变及复发感染的核心原因，结合最新临床指南与相关文献复习，系统探讨此类复杂病例的一种可行的挽救性治疗策略，为临床处理类似疾病提供实践参考。

Abstract: Incisional hernia is a common complication following abdominal surgery. Giant incisional hernia, characterized by substantial tissue loss and compromised biomechanical stability, poses significant challenges for repair. When concurrent with an abdominal wall abscess, infection and structural defect exacerbate each other, creating a vicious cycle of “infection-tissue destruction-hernia recurrence-worsening infection.” This article presents the case of a 57-year-old female with a recurrent giant incisional hernia and abdominal wall abscess. The patient had a prior history of hepatobiliary surgery (initially laparoscopic, converted to open) and underwent four hospital admissions for interventions including mesh repair, abscess drainage, mesh excision, and eventual biological mesh reconstruction. Through a detailed analysis of the clinical presentation, imaging features, evolution of surgical strategies, and the core etiological factors contributing to recurrent infection—integrated with a review of current clinical guidelines and relevant literature—this report systematically discusses a viable salvage strategy for such complex cases. It aims to provide a practical reference for the clinical management of similar conditions.