Traumatic abdominal wall hernia: a reappraisal.

Department of Surgical Disciplines, All India Institute of Medical Sciences, 29, New Delhi, India.
Hernia (Impact Factor: 2.09). 09/2004; 8(3):277-80. DOI: 10.1007/s10029-003-0203-4
Source: PubMed

ABSTRACT 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.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Introduction: Ventral hernias may be primary or incisional and classified as midline ventral hernias (MVHs) or non-MVHs (NMVHs). NMVHs are rarer, and their laparoscopic management is technically challenging because of varied anatomic locations, differences in patient positioning at time of surgery, and lack of adequate lateral space for mesh fixation, compounded by the proximity of major organs and bony landmarks. A retrospective review of all the NMVHs operated on in a clinical unit is presented. Subjects and Methods: One hundred eighty-three cases met the criteria of ventral hernia, with 25 cases (13.66%) as NMVH. These NMVHs included lumbar (n=5), suprapubic (n=7), iliac (n=10), and subcostal (n=3). Univariate and multivariate analyses were done using SPSS version 19 software (IBM, Armonk, NY). Continuous data were analyzed using the Mann-Whitney U test/t test, and categorical data were analyzed using the chi-squared test. A P value of ≤.05 was considered significant. Results: Demographic profile and presentation were similar in all groups. One case each had seromuscular intestinal injury in the iliac group (P=.668), splenic injury in the lumbar group, and liver injury in the subcostal group (P=.167). In the iliac group there was 1 patient with hematoma (P=.668), whereas seroma was seen in 1 lumbar group patient and 2 iliac group patients (P=.518). Persistent cough impulse was seen in 1 case each in the iliac and lumbar groups (P=.593). One case in the iliac group recurred after primary surgery (P=.668). Conclusions: NMVHs have a similar spectrum of difficulty and complication profile as those of laparoscopic MVH repairs. Laparoscopic repair of a non-midline hernia is technically challenging but definitely feasible. The incidence of complications and recurrence rate might be more than those for MVHs, but its actual validation needs a much larger comparative study having a longer follow-up.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 06/2014; 24(7). DOI:10.1089/lap.2013.0381 · 1.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Traumatic abdominal wall hernia after blunt trauma is a rare entity. They can easily be overlooked in patients who have multiple trauma, as its signs and symptoms may be variable due to the presence of multiple injuries. Imaging with computed tomography or ultrasound confirms the diagnosis as well as identifying any associated injuries. Although surgery is the standard treatment for traumatic abdominal wall hernias, there is no consensus on the early or late repair of the defect. Some authors recommend early surgical intervention in order to avoid the risk of intra-abdominal organ injury, incarceration, and strangulation. In this study, we report our experience in three cases, which did not involve emergency surgery. Long-term outcome is successful. Elective hernia repair may be safe and feasible in stable patients.
    The Indian journal of surgery 05/2014; DOI:10.1007/s12262-014-1083-9
  • [Show abstract] [Hide abstract]
    ABSTRACT: Traumatic abdominal wall hernias (TAWHs) are rare. Their diagnosis is mostly clinical and can be overlooked in the setting of trauma and distracting injuries or they can be misinterpreted as parietal hematomas. Associated lesions can influence decision making regarding time of operation and surgical technique. Our case highlights the management of a high-energy TAWH that associates a small bowel traumatic lesion. Surgical repair of TAWHs should follow general hernia repair principles. Further exploration of surgical options is necessary for a consensus to be reached.
    Indian Journal of Surgery 02/2015; DOI:10.1007/s12262-015-1238-3 · 0.27 Impact Factor

Similar Publications