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Central perineal hernia mimicking rectocele: a case report

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Abstract

Background

A perineal hernia is a very rare clinical finding. Three forms are distinguished: anterior, posterior, and central. Diagnosis of the last one is difficult, and sometimes, it is falsely named a posterior rectocele.

Aim

This work presents a successfully treated case of central perineal hernia and makes a brief summary of existent literature on the problem.

Presentation of the case

We report of a 67-year-old female patient with a symptomatic central pelvic floor hernia. After radiological confirmation of the diagnosis, a transperitoneal approach was chosen to reposition the protruded segment of the small bowel. The hernial orifice was closed by extraperitoneal implantation of a polypropylene mesh.

Discussion

In the present case, the use of a laparoscopic technique seemed unsuitable due to the extension of the findings. For the repair of perineal hernia, we followed the principles of the “tension-free” concept. If there are no signs of a pelvic floor infection and if the mesh can be implanted totally extraperitoneally, we recommend the use of nonabsorbable alloplastic material (polypropylene) for reinforcement of the pelvic floor as a suitable technique for the repair of large perineal hernias.

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Correspondence to Dirk Weyhe.

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Weyhe, D., Geier, B., Belyaev, O. et al. Central perineal hernia mimicking rectocele: a case report. Langenbecks Arch Surg 391, 43–46 (2006). https://doi.org/10.1007/s00423-005-0007-3

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  • DOI: https://doi.org/10.1007/s00423-005-0007-3

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