DR. ANUSUYA C,PROF. DR. MUTHUKUMARAN G,DR. TOUZEEN HUSSAIN,DR. MOHAN VALIATHAN
DOI: https://doi.org/Background:
Sub-xiphoid incisional hernias are rare postoperative complications, often following median sternotomy or upper midline laparotomy. Surgical repair is technically demanding due to the proximity to the diaphragm, sternum, and great vessels. Risk factors such as diabetes, hypertension, and coronary artery disease complicate perioperative management.
Case Presentation:
A 68-year-old female presented with a 1.5-year history of a progressively enlarging swelling in the sub-xiphoid region, following coronary artery bypass grafting (CABG). The swelling was reducible and associated with dull pain and exertional dyspnoea. CT imaging confirmed a 3×3 cm incisional hernia without strangulation. After multidisciplinary optimization of comorbidities, the patient underwent open onlay mesh repair. Intraoperatively, the defect was closed with prolene sutures and reinforced with a 10×10 cm polypropylene mesh. The postoperative course was uneventful, and the patient was discharged on day 5.
Conclusion:
This case demonstrates that with adequate multidisciplinary planning and optimization of comorbidities, open onlay mesh repair is a safe and effective treatment for sub-xiphoid incisional hernias, even in high-risk patients.
