EP.FRI.35 Traumatic abdominal wall hernia (TAWH) in a 16 year old boy

Abstract Definition Traumatic abdominal wall hernia is defined as: herniation of viscera through disrupted musculature & fascia associated with forceful trauma without skin penetration & no evidence of prior hernia defect prior to trauma Introduction There are only about 30 reported cases of TAWH due to handlebar injury, it is a rare complication of blunt abdominal trauma it involves disruption of abdominal wall muscles with bowel loops herniating through the abdominal wall defect & may be accompanied by serious or lethal complications Case report A 16 year old boy received trauma while cycling at about: 5 miles/hour & landed in the handle-bar with his right lower abdominal wall against the handle, the patient's vital signs were stable but there was bruising in the area, the diagnosis was missed by A&E doctor, but I saw him O/E there was a positive cough impulse & the diagnosis was confirmed by US examination, his haematological & biochemical investigations were normal, patient was taken to theatre & the hernia was repaired (image 2 & 3) Conclusion our case highlights the importance of clinical examination in blunt abdominal trauma & high index of suspicion plus using US/CT as appropriate to rule out mesenteric or visceral injury

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Blunt abdominal trauma leading to acute abdominal wall hernia: a case report

Nepal Journal of Medical Sciences ◽

10.3126/njms.v5i1.36961 ◽

2020 ◽

Vol 5 (1) ◽

pp. 86-90

Author(s):

D Sharma ◽

Santosh Shrestha ◽

R Ghimire

Keyword(s):

Case Report ◽

Abdominal Wall ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Abdominal Wall Hernia ◽

Abdominal Hernia ◽

Traumatic Abdominal Wall Hernia ◽

Traumatic Abdominal Hernia

Acute traumatic abdominal wall hernia is a rare but serious diagnosis resulting from blunt abdominal trauma. The challenge of managing acute traumatic abdominal hernia is approach and timing of repair. We describe a 32 years male patient’s acute traumatic abdominal wall hernia and its management.

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Traumatic abdominal wall hernia after blunt abdominal trauma caused by a handlebar in children: A well-visualized case report

Surgery ◽

10.1016/j.surg.2011.02.020 ◽

2012 ◽

Vol 151 (6) ◽

pp. 899-900 ◽

Cited By ~ 6

Author(s):

Sebastian Decker ◽

Carsten Engelmann ◽

Christian Krettek ◽

Christian W. Müller

Keyword(s):

Case Report ◽

Abdominal Wall ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Abdominal Wall Hernia ◽

Traumatic Abdominal Wall Hernia

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Complete Abdominal Wall Disruption With Herniation Following Blunt Injury: Case Report and Review of the Literature

International Surgery ◽

10.9738/intsurg-d-14-00079.1 ◽

2015 ◽

Vol 100 (3) ◽

pp. 531-539 ◽

Cited By ~ 10

Author(s):

Thomas Surya Suhardja ◽

Mohamed Anwar Atalla ◽

Warren Matthew Rozen

Keyword(s):

Abdominal Wall ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

English Literature ◽

Abdominal Wall Hernia ◽

Blunt Injury ◽

Solid Organ ◽

Review Of The Literature ◽

Traumatic Abdominal Wall Hernia ◽

Rare Type

Acute traumatic abdominal wall hernia (TAWH) is a rare type of hernia that occurs after a low- or high-velocity impact of the abdominal wall against a blunt object. With few cases reported, a consensus in diagnosis and management has not been established in the literature. A systematic review of the literature for adult cases of traumatic abdominal wall hernia due to blunt abdominal trauma was undertaken. All original articles were reviewed and data were compiled and tabulated qualitatively. Diagnostic imaging modalities and their reported description of the abdominal wall hernia were detailed correlated with the laparotomy findings. We also report a case of TAWH following blunt abdominal trauma, and describe integration of this management into clinical practice. Fifty-five cases of adult TAWH were found in the English literature. Most hernias contained either small bowel (69%) or large bowel (36%), with 16% of TAWH containing both. Concurrent intra-abdominal injuries were seen in 60% of cases, with an almost equal number of associated bowel (44%) and solid organ (35%) injuries. Twenty percent of diagnosis of TAWH was delayed, ranging from 2 days to 9 years. While TAWH is uncommon, a high index of suspicion is required in patients who present with blunt abdominal trauma. A staging system for TAWH can facilitate appropriate management priorities and treatment. CT scanning is crucial in the diagnosis of TAWH, and aids in definitive management of these patients. The literature supports immediate surgical exploration for most TAWH.

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