Images in Clinical Medicine
Abdominal Pseudohernia Due to Herpes Zoster
N Engl J Med 2006; 355:e1July 6, 2006
- Article
A vesicular rash of the right T11–T12 dermatomes developed in a 75-year-old man. Four weeks later, as the rash was resolving (Panel A), he noticed a protrusion of the right abdominal wall associated with skin pain (Panel B). Examination revealed a pseudohernia of the abdominal wall measuring 5 by 5 cm, hypesthesia of the overlying skin, and upward and leftward movement of the umbilicus on abdominal flexion. Magnetic resonance imaging (MRI) of the abdomen did not reveal a hernia or mass. Electromyography revealed denervation changes limited to the right thoracic paraspinal and infraumbilical muscles (T11–T12 myotomes). MRI of the thoracic and lumbar spine was unrevealing. Herpes zoster is a viral disease of the dorsal-root ganglia and sensory-nerve fibers that is characterized clinically by unilateral vesicular eruption of the skin and painful sensory changes in a dermatomal distribution. Segmental motor weakness is an uncommon complication that occurs in 3 to 5 percent of patients with herpes zoster and is associated with a good prognosis for recovery.
N. Troy Tagg, M.D.
Jack W. Tsao, M.D., D.Phil.
Walter Reed Army Medical Center, Washington, DC 20307- Citing Articles (3)
Citing Articles
1
Elias Dakwar, Tien V. Le, Ali A. Baaj, Anh X. Le, William D. Smith, Behrooz A. Akbarnia, Juan S. Uribe. (2011) Abdominal wall paresis as a complication of minimally invasive lateral transpsoas interbody fusion. Neurosurgical FOCUS 31:4, E18
CrossRef2
Wim Opstelten, Janet McElhaney, Birgit Weinberger, Anne Louise Oaklander, Robert W. Johnson. (2010) The impact of varicella zoster virus: Chronic pain. Journal of Clinical Virology 48, S8-S13
CrossRef3
A. Durham-Hall, S. Wallis, I. Butt, B. M. Shrestha. (2009) Abdominal wall pseudohernia following video-assisted thoracoscopy and pleural biopsy. Hernia 13:1, 93-95
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