Authors
Hannah Tan, Caleb W Brown, Phillip L Nichols, Derek C Wenger, Jeremy M Powers
Published in
Cureus. Volume 18. Issue 7. Pages e112024. Epub Jul 03, 2026.
Abstract
Redundant pannus after massive weight loss can impair function and obscure abdominal wall pathology. Incisional hernia after cesarean delivery is uncommon, and extension of the small bowel into a post-bariatric pannus is particularly unusual. We report a 42-year-old woman with three prior cesarean deliveries and prior bariatric surgery who presented with a functionally limiting grade 3 pannus and a long-standing, nonreducible lower abdominal bulge. Computed tomography (CT) demonstrated a 12.3 cm × 5.6 cm low ventral incisional hernia with a 6.7 cm neck containing small bowel loops extending into the pendulous pannus. A single-stage operation involving plastic and general surgery was planned for combined panniculectomy and Rives-Stoppa repair. The patient underwent panniculectomy with umbilical sacrifice for exposure, bilateral retrorectus dissection with myofascial release, posterior sheath closure, and Rives-Stoppa repair using a 20 cm × 25 cm retrorectus mesh. She was discharged on postoperative day 1. A symptomatic retrorectus seroma developed within the first postoperative month and was successfully managed with image-guided percutaneous drainage; cultures were negative, and no recurrence or wound breakdown was present at three-month follow-up. This case highlights the value of multidisciplinary planning and carefully selected single-stage panniculectomy with retromuscular hernia repair for complex abdominal wall defects concealed by a post-bariatric pannus.
PMID:
42548834
Bibliographic data and abstract were imported from PubMed on 04 Aug 2026.
Read full publication at:
Please sign in
to see all details.
Advertisement
Stats
- Recommendations n/a n/a positive of 0 vote(s)
- Views 8
- Comments 0