Blunt Traumatic Abdominal Aortic Dissection and Concomitant Traumatic Abdominal Wall Hernia and Small Bowel Injury: A Surgical Conundrum

Mooty, R. Clark; Mangram, Alicia; Johnson, Van; Truitt, Michael S.; Jefferson, Henry; Dunn, Erica H.

doi:10.1177/000313481007600845

Cited by 5 publications

(2 citation statements)

References 4 publications

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“… 1 Some authors have recently advocated use of the biologic mesh in cases with concurrent hollow viscous injuries, or abdominal contamination and abdominal wall hernia, although this condition has historically been considered a contraindication for usage of mesh. 8,9 Although use of biologic mesh in such cases seem to be safe with good immediate and short-term results, the long-term durability is less favorable, with some series citing a hernia recurrence rate of 40% in a mean follow up period of 21 months. 9 …”

Section: Discussionmentioning

confidence: 99%

Abdominal wall hernia and aortic injury secondary to blunt trauma: Case report and review of the literature

Ballard

Kaskas

Jahromi

et al. 2014

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Abdominal wall hernia and aortic injury secondary to blunt trauma: Case report and review of the literature

Ballard

Kaskas

Jahromi

et al. 2014

International Journal of Surgery Case Reports

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“…Differently to this, the management of intra-abdominal aortic injuries offers a widespread of possible treatments, starting with conservative treatment, the use of minimal invasive applied stents and surgery with suturing or replacement ( 22 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

Open Repair Versus Thoracic Endovascular Aortic Repair in Multiple-Injured Patients: Observations From a Level-1 Trauma Center

et al. 2015

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Background:Blunt trauma of the thoracic aorta is a rare but potentially life-threatening entity. Intimal tears are a domain of non-operative management, whereas all other types of lesions should be repaired urgently. There is now a clear trend favoring minimally invasive stent grafting over open surgical repair.Objectives:The aim of the present study was to retrospectively evaluate the mortality and morbidity with either treatment option. Therefore, a retrospective observational study was performed to compare two different treatment methods at two different time periods at one trauma center.Patients and Methods:Between 1977 and 2012, all severely injured patients referred to our level 1 trauma center were screened for blunt aortic injuries. We compared baseline characteristics, 30-day and overall mortality, morbidity, duration of intensive care treatment, procedure time, and transfusion of packed red blood between patients who underwent open surgical or stent repair.Results:During the observation period, 45 blunt aortic injuries were recorded. The average Injury Severity Score (ISS) was 41.8 (range 29 - 68). Twenty-five patients underwent Open Repair (OR), and another 20 patients were scheduled to emergency stent grafting. The 30-day mortality in the surgical and stent groups were 5/25 (20%) and 2/20 (10%), respectively. The average time for open surgery was 151 minutes; the mean time for stent grafting was 67 minutes (P = 0.001). Postoperative stay on the intensive care unit was between one and 59 days (median 10) in group one and between four and 50 days in group two (median 26)(P = 0.03). Patients undergoing OR required transfusion of 6.0 units of packed red cells in median; patients undergoing stent grafting required a median of 2.0 units of packed red cells (P < 0.001). In the stent grafting group, 30-day mortality was 10% (2/20).Conclusions:Due to more sophisticated diagnostic tools and surgical approaches, mortality and morbidity of blunt aortic injuries were significantly reduced over the years compared to thoracic endovascular aortic repair and OR over two different time periods.

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Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

Kearney

Dumanian

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique. Methods: We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications. Results: The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4–48.7 months). Conclusions: Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.

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Blunt Traumatic Abdominal Aortic Dissection and Concomitant Traumatic Abdominal Wall Hernia and Small Bowel Injury: A Surgical Conundrum

Cited by 5 publications

References 4 publications

Abdominal wall hernia and aortic injury secondary to blunt trauma: Case report and review of the literature

Abdominal wall hernia and aortic injury secondary to blunt trauma: Case report and review of the literature

Open Repair Versus Thoracic Endovascular Aortic Repair in Multiple-Injured Patients: Observations From a Level-1 Trauma Center

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

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