Incisional Ventral Hernia with Loss of Domain Containing Right Kidney and Pancreas Head Inside

A 70-year-old man with history of obesity, diabetes, umbilical herniorrhaphy, incisional ventral hernia repaired in 2 occasions, two intestinal obstructions, and two acute lithiasic pancreatitis. Presence of supraumbilical incisional ventral hernia (M2-4W3) in a midline, with a defect of 21 x 15 cm. Abdominal cavity volume of 43 x 28 x 19 cm, with an estimated volume of 22 litres, herniated volume of 43 x 38 x 12 cm, with an estimated volume of 20.2 litres and ratio greater than 25 % (87.5 %). Among the herniated viscera are small bowel, bladder dome, duodenum, head of pancreas and right kidney.