Hernia Development After Traumatic Injury to the Pelvic Ilium: Case Report and Novel Approach to Repair

A Case of Iliac Crest Avulsion with Peritoneal Disruption and Bowel Herniation after Blunt Trauma

“…6 Bowel herniation may even occur years after initial injury, as in the case of a patient that presented with right gluteal bulge and right lower quadrant abdominal pain six years after blunt trauma. 5 The repair of these injuries should follow the same basic tenants of all hernia repairs, including reduction of herniated contents and obliteration of the defect with tensionfree repair. 7 Repair options vary based on timing of diagnosis, associated health of the bowel, and level of intraabdominal contamination.…”

“…13 However, this is not often possible in the setting of trauma due to open contaminated wounds or bowel disruption. 5 When the hernia is repaired in a delayed manner after trauma or iliac crest harvest, several other repair options have been described including a transperitoneal, retroperitoneal, and posterior approach. 7,8,13 Moon et al described a retroperitoneal approach utilizing fibular bone scaffolding to repair a traumatic hernia, which was discovered six years after injury.…”

“…7,8,13 Moon et al described a retroperitoneal approach utilizing fibular bone scaffolding to repair a traumatic hernia, which was discovered six years after injury. 5 Repair of herniation after iliac crest harvesting has commonly been described via a posterior approach through previous scar from grafting site. The defect has been obliterated with soft tissue of gluteal fascia, iliacus muscle, and external oblique muscle.…”

“…4 Though bowel herniation has been reported to occur after autogenous bone grafting from the iliac crest, there has been approximately 30 cases of bowel herniation associated with traumatic pelvic fractures described in the literature over the last 100 years. 5,6 This rare complication requires a high index of suspicion for timely diagnosis. Furthermore, even when appropriately identified, treatment can be challenging.…”

A Case of Pancreatic Intraductal Tubular Carcinoma: A Rare Entity with Improved Prognosis

“…13 However, this is not often possible in the setting of trauma due to open contaminated wounds or bowel disruption. 5 When the hernia is repaired in a delayed manner after trauma or iliac crest harvest, several other repair options have been described including a transperitoneal, retroperitoneal, and posterior approach. 7, 8, 13 Moon et al described a retroperitoneal approach utilizing fibular bone scaffolding to repair a traumatic hernia, which was discovered six years after injury.…”