Perineal Hernia Following Abdominoperineal Amputation and Myocutaneous Flap

Perineal hernia after infralevator posterior pelvic exenteration due to adenocarcinoma of the lower rectum with genital invasion: a rectus abdominis myocutaneous flap was used to repair the defect and reconstruct the vagina. The donor abdominal fascia area was reinforced with bio-absorbable mesh (BioA^®-Gore).

On CT, ileal loops were observed with elongated mesentery in the pelvis and perineum, and “donor” parietal weakness (without sac) (Fig. 1).

Figure 1

The myocutaneous flap itself was not able to prevent the development of a perineal hernia after abdominal-perineal resection, nor did absorbable mesh avoid the parietal defect created by removing the anterior fascia of the rectal muscle.