scholarly journals A concealed small bowel perforation in an adult secondary to bicycle handlebar trauma

2013 ◽  
Vol 95 (4) ◽  
pp. e4-e5 ◽  
Author(s):  
SC Ghosh ◽  
GJ Nolan ◽  
RR Simpson
Keyword(s):  
Small Bowel ◽  
Abdominal Wall ◽  
Bowel Perforation ◽  
Abdominal Wall Hernia ◽  
Solid Organ ◽  
Small Bowel Perforation ◽  
Traumatic Abdominal Wall Hernia ◽  
Close Inspection ◽  
Rare Injury ◽  
Low Threshold

Traumatic abdominal wall hernia (TAWH) secondary to bicycle handlebar is a rare injury. The majority of the literature describes abdominal wall herniation in children. We present a rare case of TAWH in an adult with a concealed small bowel perforation. Although clinical examination in conjunction with computed tomography can exclude the majority of solid organ injuries, small bowel injuries can often be missed. Our case initially revealed a serosal tear in the small bowel but, on close inspection, a separate 3mm perforation was identified, hidden in the small bowel mesentery. We strongly support a low threshold for operative intervention if there is any suspicion. Moreover, we stress the importance of meticulous examination during laparotomy as this injury could have been easily missed, resulting in potential morbidity or mortality in a patient sustaining such an injury.

scholarly journals Traumatic Abdominal Wall Hernia Associated with Small Bowel Injury—Case Report

2015 ◽  
Vol 77 (S1) ◽  
pp. 174-176 ◽  
Author(s):  
Vlad Constantin ◽  
Alexandru Carâp ◽  
Simona Bobic ◽  
Mădălina Albu ◽  
Elvira Nica ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Bowel Injury ◽  
Small Bowel Injury ◽  
Traumatic Abdominal Wall Hernia

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

2015 ◽  
Vol 100 (3) ◽  
pp. 531-539 ◽  
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.

scholarly journals Isolated Small Bowel Perforation Following Blunt Trauma

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
G Dhayalan ◽  
AH Junaidi ◽  
MS Salleh ◽  
K Aina
Keyword(s):  
Small Bowel ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Bowel Perforation ◽  
Abdominal Injury ◽  
Organ Injury ◽  
Free Fluid ◽  
Solid Organ ◽  
Small Bowel Perforation ◽  
Left Femur

  Small bowel perforation is common following blunt abdominal trauma. Intra-abdominal injury with isolated small bowel perforation however, is a rare entity and diagnosis can be ambiguous. Nonisolated small bowel perforation, which carries a higher mortality rate, will be identified early during the assessment of the patient following a blunt abdominal trauma. A case of an isolated small bowel perforation following a road traffic accident is reported. A motorcycle rider, while trying to avoid a car, lost control and skidded into a drain. Upon arrival to the Emergency Department, he was complaining of upper abdominal pain evident by abrasion and bruising of his bilateral hypochondriacs. FAST scan showed free fluid at Morrison’s pouch and a formal abdominal ultrasound confirmed minimal free fluid at Morrison’s pouch. A plain CT abdomen was done and did not show any evidence of solid organ injury but demonstrated pneumoperitoneum. In view of the persistent abdominal tenderness, open fracture of left femur, radius and ulna, and radiological findings, a laparotomy was performed which revealed an isolated 1x1cm small bowel perforation, 60cm from DJ junction with localized faecal contamination. Small bowel repair was done and patient recovered well afterward. Although challenging, due to its detrimental infectious potential, early recognition of small bowel injury is crucial. Isolated small bowel perforation, rarely without associated intra-abdominal injury, requires more investigations, delaying diagnosis to treatment period. CT abdomen has proven to be both specific and sensitive in diagnosing small bowel injuries. Even when physical examination and radiological examinations are minimal, a suspicion of small bowel perforation should be considered as delay in diagnosis eventually increases morbidity and mortality.

scholarly journals Bowel obstruction and perforation secondary to barbed suture after minimally invasive inguinal hernia repair: report of two cases and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Liming Wang ◽  
Taku Maejima ◽  
Susumu Fukahori ◽  
Shoji Nishihara ◽  
Daitaro Yoshikawa ◽  
...  
Keyword(s):  
Small Intestine ◽  
Inguinal Hernia ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bowel Perforation ◽  
Barbed Suture ◽  
Small Bowel Perforation ◽  
Peritoneal Closure ◽  
Pubmed Database

Abstract Background Laparoscopic transabdominal preperitoneal patch (TAPP) is now commonly used in the repair of inguinal hernia. Barbed suture can be a fast and effective method of peritoneal closure. We report two rare cases of small bowel obstruction and perforation caused by barbed suture after TAPP. Cases Patient 1 is a 45-year-old man who underwent laparoscopic repair of a right inguinal hernia. Barbed suture was used to close the peritoneal defect. At 47 days after the operation, he was diagnosed with a small bowel obstruction caused by an elongated tail of the barbed suture. Emergency laparoscopic exploration was performed for removal of the embedded suture and detorsion of the volvulus. The second patient is a 50-year-old man who was admitted with a small bowel perforation one week after TAPP herniorrhaphy. Emergency exploration revealed that the tail of the barbed suture had pierced the small intestine, causing a tiny perforation. After cutting and releasing the redundant tail of the barbed suture, the serosal and muscular defect was closed with 2 absorbable single-knot sutures. Both patients have recovered well. Finally, we searched the PubMed database and reviewed the literature on the effectiveness and safety of barbed suture for TAPP. Conclusions Surgeons should understand the characteristics of barbed suture and master the technique of peritoneum closure during TAPP in order to reduce the risk of bowel obstruction and perforation.

scholarly journals Parasitic leiomyoma causing small bowel perforation: A case report

2021 ◽  
pp. e00349
Author(s):  
Anya Laibangyang ◽  
Cassandra Law ◽  
Gunjan Gupta ◽  
Xiang Da Dong ◽  
Linus Chuang
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Bowel Perforation ◽  
Small Bowel Perforation

scholarly journals A very persistent chicken bone: two separate perforations from the same foreign object 2 months apart

2019 ◽  
Vol 12 (5) ◽  
pp. e228050
Author(s):  
Andrew James Brown ◽  
Thomas Whitehead-Clarke ◽  
Vera Tudyka
Keyword(s):  
Small Bowel ◽  
Bowel Perforation ◽  
Linear Structure ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Small Bowel Perforation ◽  
Chicken Bone ◽  
Abdomen Ct ◽  
Distal Migration ◽  
The Right

A 56-year-old man presented acutely with abdominal pain and raised inflammatory markers. Initial CT images demonstrated acute inflammation in the right upper quadrant surrounding a high-density linear structure. The appearance was of a chicken bone causing a contained small bowel perforation. This was managed conservatively with intravenous antibiotics and the patient was discharged 10 days later. The same patient returned to the hospital 2 months later, once again with an acute abdomen. CT imaging on this occasion showed distal migration of the chicken bone as well as free gas and fluid indicative of a new small bowel perforation. The patient underwent an emergency laparotomy, washout and small bowel resection. No foreign body was found at laparotomy or in the histopathology specimen. The postoperative course was complicated by an anastomotic leak. A further CT on that admission demonstrated that the chicken bone had migrated to the rectum!

Traumatic Abdominal Wall Hernia

2014 ◽  
Vol 81 (12) ◽  
pp. 1409-1410 ◽  
Author(s):  
Giorgio Persano ◽  
Enrico Pinzauti ◽  
Roberto Lo Piccolo ◽  
Antonio Messineo ◽  
Marco Ghionzoli
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Hernia ◽  
Traumatic Abdominal Wall Hernia
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