• Min Soo Choi, Myung Hun Jang, Byeong Ju Lee, Yong Beom Shin, and Sang Hun Kim.
• Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital.
• Medicine (Baltimore). 2021 Mar 5; 100 (9): e24973e24973.

RationaleAn abdominal pseudohernia is a protrusion of the abdominal wall that there is no actual muscular disruption. This report presents a case in which abdominal muscle activities were accurately and quantitatively measured using ultrasonography (US) and surface electromyography in a patient with abdominal pseudohernia.Patient ConcernsA 62-year-old man presented with a marked protrusion on the left abdomen with increasing abdominal pressure.DiagnosesFirst, the thickness of the abdominal muscle was measured with US while the patient constantly blew the positive expiratory pressure device. When the force was applied to the abdomen, the mean thickness of the muscle layer on the lesion site was found to be thinner. Second, the activities of the abdominal muscles were measured using surface electromyography by attaching electrodes to 8 channels at the same time. When the same pressure was applied on both sides of the abdomen, more recruitment occurred to compensate for muscle weakness at the lesion site. Through the previous 2 tests, the decrease in muscle activity in the lesion area could be quantitatively evaluated. Third, the denervation of the muscle was confirmed using US-guided needle electromyography.InterventionsThe patient in this case was wearing an abdominal binder. In addition, he had been training his abdominal muscles through McGill exercise and breathing exercises such as with a positive expiratory pressure device.OutcomesThe patient was able to understand his symptoms. A follow-up test will be performed to see if there is any improvement.LessonsBy using these outstanding assessment methods, proper diagnosis and rehabilitation treatment strategies can be developed.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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