Abdominal Pseudohernia Due to Herpes Zoster
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《新英格兰医药杂志》
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
N. Troy Tagg, M.D.
Jack W. Tsao, M.D., D.Phil.
Walter Reed Army Medical Center
Washington, DC 20307