Abdominal Wall Pseudohernia Secondary to Subcostal Nerve Entrapment After Lateral Spinal Surgery: A Case Report.
Nicole Rossi, Sanjeev Puri
✦ AI-curated · Sources linked
Case in brief
A 75-year-old man with a history of multiple spinal operations developed persistent laxity of the left lateral abdominal wall, consistent with a pseudohernia. The laxity persisted for 1 year despite conservative management, prompting surgical exploration. There was no fascial defect described; instead, dense perineural fibrosis completely encased the subcostal nerve, which showed a diminished motor response to stimulation. Neurolysis decompressed the nerve and restored abdominal muscle contraction. The abdominal wall laxity resolved completely within 1 month after surgery.
What made this case unusual
Exploration identified complete subcostal nerve encasement by dense perineural fibrosis, linking nerve entrapment to the pseudohernia after lateral spinal surgery.
Diagnostic / clinical pearl
Abdominal wall laxity without a fascial defect after lateral spinal surgery may reflect denervation from subcostal nerve entrapment; exploration in this case identified fibrosis and diminished nerve stimulation response.