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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 × 15 cm. Abdominal cavity volume of 43 × 28 × 19 cm, with an estimated volume of 22 litres, herniated volume of 43 × 38 × 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.

Incisional ventral hernia with loss of domain containing right kidney and pancreas head inside