Publication:

Delayed onset post-herpetic pseudohernia: a case report

Post herpetic pseudo hernia is a rare neurological complication of herpes zoster (HZ). It could lead to diagnostic confusion as abdominal wall herniation presents with similar clinical picture. We present a case of post herpetic pseudo hernia initially misdiagnosed by referring general physician as abdominal wall hernia. A 60-year-old man presented with painless swelling in the right flank for 1 week. The bulge was noticed two weeks after appearance of painful rash of HZ. On clinical examination, fading dried brown rashes were observed in right T10-11 dermatome. No hernial defect was palpable. The bulge became more prominent on standing and coughing. Abdominal sonography report was normal with absence of abdominal mass or hernial defect. The patient was diagnosed as a case of post herpetic pseudo hernia. The bulge resolved spontaneously in 3 months. Physicians should consider the possibility of Post herpetic pseudo hernia if abdominal bulge appears following HZ infection to prevent unnecessary interventions.