Traumatic abdominal wall hernia: A reappraisal

Department of Surgical Disciplines, All India Institute of Medical Sciences, 29, New Delhi, India.
Hernia (Impact Factor: 2.05). 09/2004; 8(3):277-80. DOI: 10.1007/s10029-003-0203-4
Source: PubMed


Traumatic abdominal wall hernia, a rare cause of hernia, has a confusing clinical picture and requires a high index of suspicion for prompt diagnosis and management. Such hernias, if missed, can result in high morbidity and may prove fatal. Distinction from a pre-existing hernia is important as well. We report our experience in two such cases, which had presented in a span of 9 months, and submit a brief analysis of 50 reviewed cases.

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    • "Traumatic disruption of the abdominal wall is very rare, with only about 50 reports worldwide, and only one from India [1]. Not surprisingly, many cases have been reported in children, given their weaker parietal wall and more elastic skin [2]-[4]. "
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    ABSTRACT: Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management. A 40-year-old woman from rural north India presented with a low-velocity blunt injury to the lower abdomen. She was attacked by a bull. She had a clinically evident abdominal fascial disruption with intact skin, and was hemodynamically stable. An emergency mesh repair of the defect was performed, and she recovered well. A 38-year-old man from rural north India presented with blunt trauma to the abdomen following a motor vehicle accident. He was stable, with a central abdominal parietal wall swelling and bruising. A computed tomography scan revealed herniation of bowel loops in the area with minor intra-abdominal injuries. A laparotomy, resection-anastomosis of the ischemic bowel, and primary repair of the defect was performed and he recovered well. Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.
    Journal of Medical Case Reports 06/2009; 3(1):7324. DOI:10.4076/1752-1947-3-7324
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    ABSTRACT: Traumatic abdominal wall hernias are a type of acquired hernia secondary to blunt trauma Caused, by direct trauma from handlebar like objects. This rare hernia is named 'Handlebar hernia'. We report a case of such hernia without any significant intra-abdominal injury. The abdominal wall defect was repaired in layers by Jones technique. Postoperative course was uneventful. The authors recommend clinical suspicion for traumatic hernia in all patients with traumatic abdominal wall injury. Definitive treatment includes surgical exploration with primary repair of all tissue layers of the abdominal wall.
    Acta medica Iranica 48(5):351-2.
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    ABSTRACT: To review blunt traumatic abdominal wall hernias (TAWHs) in our institution. Retrospective review of blunt abdominal trauma cases over a 6-month period. Four patients with TAWH were identified. The mean age was 36 years. Three had been involved in vehicular collisions, and 1 had been assaulted with a large stone. All were diagnosed on presentation, 3 by computed tomography scan and 1 clinically. Two were repaired as emergencies, and 1 was repaired after 4 months. The 4th patient refused surgery. This uncommon injury requires a high index of suspicion and a low threshold for intervention. CT scan offers the best imaging potential.
    South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie 06/2005; 43(2):41-3. · 0.40 Impact Factor
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