Segmental zoster abdominal paresis mimicking an abdominal he
A 58-year-old male presented to our hospital with 2 weeks’ history of rash and a week history of the protrusion in the right abdominal wall with no pain. He had no history of diabetes mellitus or surgery. Physical examination revealed a healed herpetic skin rash and a 20 × 10 cm marked bulge on the right side of his abdomen in the area innervated by the 9th to 11th thoracic nerves.

The bulge became more pronounced with increased abdominal pressure. Limb activity and muscle strength are normal. Initially, a surgeon from the Department of abdominal wall surgery suspected it as an abdominal hernia, while ultrasonography revealed no the abdominal wall defect or mass, then a dermatologist diagnosed it as segmental herpes zoster abdominal paralysis which is a motor complication of Herpes zoster, mimicking an abdominal hernia. He was treated with oral acyclovir (800 mg 5 times daily for 7 days), mecobalamin (500 mg 3 times daily for 2 months), and vitamin B1 (20 mg 3 times daily for 2 months). The abdominal bulge had remitted completely after 2 months of treatment.

Source: Medicine: April 2019 - Volume 98 - Issue 15 - p e15037

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