Abdominal herniation associated with bullhorn injury as a separate entity from traumatic abdominal wall hernias

Abstract

Bullhorn injury is a rare mechanism causing traumatic abdominal wall hernia (TAWH). Bullhorn injury needs to be discussed as a separate sub-entity among TAWHs as the mechanism of injury is such that the great force is generated at a relatively small area of impact for a short duration of time which may lead to muscle defect without compromising integrity of overlying skin (referred to as sheathed goring) leading to herniation of abdominal viscera. The purpose of this review was to discuss abdominal herniation's associated with bullhorn injury as a separate entity from TAWHs; recognize the common presentations, mechanism of injury, and modalities of treatment currently utilized for this rare condition. A comprehensive online English, Spanish, Portuguese, and French language medical literature search was done using various electronic search databases. Different search terms including MeSH related to bullhorn-injury associated injuries including abdominal wall hernias were used. An advanced search was further conducted by combining all the search fields in abstracts, keywords, and titles. We summarized the data from the searched articles and found 12 cases who underwent emergency or elective herniorrhaphy with or without the use of mesh. We have proposed a treatment algorithm for such cases in light of the present era of laparoscopy and propose the usage of the term “bullhorn-injury associated traumatic hernia” for such cases. We present here the first most comprehensive discussion of all such cases reported till date.

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

“…Traumatic abdominal wall hernias are themselves rare entities, and descriptions of primary repair are largely limited to case reports. 23 , 33 , 35 , 57 – 59 While several factors contribute to the decision of primary versus mesh-supported repair, including defect size and presence of abdominal contamination, we find that our mesh strip technique provides some of the advantages of planar mesh while avoiding the difficulties and time required to place a large sheet of prosthetic material. Cases were completed on average under 2 hours for these surgeries.…”