Colonic strangulation and perforation in traumatic abdominal hernia: unusual emergency treatment for a rare trauma complication

Benini, Bruno; Ceribelli, Cecilia; Staltari, P.; Truosolo, B.; Antonellis, Donato

doi:10.1007/s13304-011-0091-6

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…The incidence reported in the literature is < 1% of all blunt abdominal trauma. It is strongly associated with blunt abdominal trauma following road traffic accidents with 50–70% occurring after motor vehicle collisions, 15–20% after motorbike accidents, with the remainder occurring mostly after pedestrian accidents and bicycle handlebar injuries [2]. Of the numerous classification systems that exist, we use that of Dennis et al, the most frequently referenced in the literature [3] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Traumatic Abdominal Wall Hernia–A Series of 12 Patients and a Review of the Literature

et al. 2021

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Background The traumatic abdominal wall hernia (TAWH) is strongly associated with blunt abdominal trauma. The importance of the CT scan cannot be underestimated—the diagnosis of TAWH is easy to miss clinically, but simple to spot radiologically. We report a case series of patients managed in a French‐level one trauma centre, to contribute our experience in the detection and management of associated injuries, and of the hernia itself. Methods All patients (n = 4238) presenting to a single‐level one trauma centre for trauma resuscitation (including systematic full‐body computerised tomography) from November 2014 to February 2020 were screened for the presence of TAWH and prospectively added to our database. Particular attention was paid to the late detection of associated intra‐abdominal injuries. Finally, the choice of management of the hernia itself was noted. A literature review of all case series and individual case reports until the time of writing was performed and summarised. Results We report 12 cases of TAWH amongst 4238 patients presenting to the trauma resuscitation bay between November 2014 and February 2020. All patients underwent a contrast‐enhanced CT immediately after stabilisation. No patients had clinically detected TAWH prior to CT. Intra‐abdominal injuries were found in 9 patients (75%), and urgent surgery was required in 7 patients (58.3%). Two (28.5%) of these seven patients had a missed diagnosis of intra‐abdominal injury at the time of the index CT scan, although the TAWH had been detected. Based on our literature review, 271 patients across 12 case series were identified. In total, 183 (67;5%) of these patients were reported to have ≥ 1 associated intra‐abdominal injuries. In total, 127 (46,8%) patients required an urgent laparotomy for management of these injuries. Five (3.9%) of the patients requiring urgent laparotomy had a missed CT diagnosis of intra‐abdominal injury but not of TAWH at the time of the baseline CT. Conclusions TAWH is a rare clinical entity that may alert to more significant, associated trauma lesions. The CT scan is the imaging modality of choice, to both diagnose and classify the hernia and to screen for other injuries. The presence of TAWH must lower the threshold to operatively explore or at least closely monitor these patients, in view of the high rate of false‐negative findings at index imaging.

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Section: Introductionmentioning

confidence: 99%

Traumatic Abdominal Wall Hernia–A Series of 12 Patients and a Review of the Literature

et al. 2021

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“…It is strongly associated with high-energy injuries. They occur frequently after vehicle or automobile accidents of high energy 2 . An isolated traumatic abdominal wall hernia (TAWH) also known as blunt abdominal TAWH is uncommon.…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic lateral abdominal wall hernia: a case report

Abdelali

Chaouch

Jabra

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Traumatic abdominal wall hernia (TAWH) also known as blunt abdominal TAWH is uncommon. The clinical diagnosis is difficult. The authors present a case report of posthigh-energy abdominal blunt trauma causing a TAWH. Case presentation: A 36-year-women, with unremarkable past medical history, was presented to the Emergency Department after a stuck in high-speed two automobiles. She was hemodynamic, respiratory, and neurologically stable. The BMI was 36 kg/m². The abdomen was not distended with an ecchymotic lesion on the right flank. The thoracic abdominal and pelvic computed tomography (CT) scan revealed a rupture in the lateral abdominal wall muscles with a TAWH in the location of the skin ecchymoses. There was no visceral lesion or intraperitoneal fluid. A conservative treatment was indicated. The follow-up was uneventful, with hematoma resorption and no cellulitis or abscess. The patient was discharged after 1 week. An abdominal repair will be planned using a mesh. Clinical discussion: TAWH is a rare entity. The best imaging modality for diagnosis is the CT scan allowing classification of the hernia and a screen for other injuries. The presence of an isolated TAWH must lower the threshold to closely monitor or to operatively explore, given the high rate of false-negative findings at imaging features. Conclusion: TAWH should be suspected behind any blunt abdominal trauma with high energy. CT scan and ultrasound were helpful for diagnosis and the only curative treatment is surgery to avoid complications.

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Consequences of Underestimating Impalement Bicycle Handlebar Injuries in Children

Ramos

Swain

Troncoso-Munoz³

et al. 2017

Journal of Trauma Nursing

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Impalement bicycle handlebar trauma injuries are rare; however, on initial assessment, they have the potential of being underestimated. We reviewed our prospective trauma database of 3,894 patients for all bicycle injuries from January 2010 to May 2015. Isolated pedal bike injuries were reported in 2.6% (N = 101) of the patients who were admitted to the trauma service. Fifteen patients suffered direct handlebar trauma. Patients were grouped into blunt trauma (n = 12) and impalement trauma (n = 3). We examined gender, age, injury severity score (ISS), Glasgow Coma Scale score, use of protective devices, need for surgical intervention, need for intensive care (ICU), and hospital length of stay. Mean age was 9.6 years. All children with penetrating injuries were males. Mean ISS was less than 9 in both groups. None of the children were wearing bicycle helmets. Three patients who sustained blunt injuries required ICU care due to associated injuries. All of the children with impalement injuries required several surgical interventions. These injuries included a traumatic direct inguinal hernia, a medial groin and thigh laceration with resultant femoral hernia, and a lateral deep thigh laceration. Impalement bicycle handlebar injuries must be thoroughly evaluated, with a similar importance given to blunt injuries. A high index of suspicion must be maintained when examining children with handlebar impalement injuries, as they are at risk for missed or underestimation of their injuries.

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Colonic strangulation and perforation in traumatic abdominal hernia: unusual emergency treatment for a rare trauma complication

Cited by 4 publications

References 10 publications

Traumatic Abdominal Wall Hernia–A Series of 12 Patients and a Review of the Literature

Traumatic Abdominal Wall Hernia–A Series of 12 Patients and a Review of the Literature

Post-traumatic lateral abdominal wall hernia: a case report

Consequences of Underestimating Impalement Bicycle Handlebar Injuries in Children

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