Monoradiculopathy-induced abdominal pseudohernia caused by T11-12 soft disc herniation: a case report and literature review

• Published in: BMC musculoskeletal disorders 2023-05, Vol.24 (1), p.428-428, Article 428
• Main Authors: Cho, Wan-Jae, Kim, Ki-Won, Kim, Bo-Hyoung, Ryu, Ji-Hyun
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Muscles; Abdominal pseudohernia; Abdominal wall; Adult; Analysis; Anti-inflammatory agents; Care and treatment; Case Report; Case reports; Complications and side effects; Computed tomography; CT imaging; Denervation; Diabetes; Diabetes mellitus; Differential diagnosis; Dosage and administration; Flank Pain; Hernia; Hernia, Abdominal - complications; Hernia, Abdominal - diagnostic imaging; Herpes Zoster; Humans; Infections; Inflammation; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - diagnostic imaging; Intervertebral discs; Intervertebral disk; Intervertebral disk displacement; Literature review; Literature reviews; Magnetic Resonance Imaging; Male; Muscles; Musculoskeletal diseases; Nonsteroidal anti-inflammatory drugs; Outpatient care facilities; Pain; Paresis; Patients; Thoracic disc herniation; Thorax; Tomography
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06536-1

An abdominal pseudohernia is a rare clinical entity that consists of an abnormal bulging of the abdominal wall that can resemble a true hernia but does not have an associated underlying fascial or muscle defect. Abdominal pseudohernia is believed to result from denervation of the abdominal muscles in cases of herpes zoster infection, diabetes mellitus, lower thoracic or upper lumbar disc herniation, surgical injuries, and rib fracture. To date, nine cases of abdominal pseudohernia caused by disc herniation at the lower thoracic or upper lumbar levels have been reported. A 35-year-old man with no underlying disease or traumatic event presented with chief complaints of left flank pain and a protruding left lower abdominal mass that had formed one day earlier. There was no true abdominal hernia on abdominal computed tomography (CT), although CT and magnetic resonance imaging (MRI) showed a herniated soft (non-calcified) disc into the left neural foramen at the T11-12 level. A nonsteroidal anti-inflammatory drug was prescribed for the flank pain, and the patient was followed on a regular basis for six months. Follow-up MRI taken at the last visit showed complete resorption of the herniated disc. Abdominal pseudohernia and flank pain were also completely resolved. We report a rare case of monoradiculopathy-induced abdominal pseudohernia caused by foraminal soft disc herniation at the T11-12 level. In patients who have an abdominal pseudohernia without herpes zoster infection, diabetes mellitus, or traumatic events, lower thoracic disc herniations should be included in differential diagnosis.