Traumatic abdominal wall hernia: a rare and often missed diagnosis in blunt trauma

Pothiawala, Sohil; Balasubramaniam, Sunder; Taib, Mujeeb; Bhagvan, Savitha

doi:10.5847/wjem.j.1920-8642.2022.094

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…A thorough history and clinical examination are essential in the diagnosis of TAWH. Abdominal discomfort, abrasions, ecchymosis, or hematoma may be the only clinical findings, while the differential diagnosis should always include pre-existing hernias, abdominal wall hematomas, and tumors [ 8 ]. Nonetheless, since the clinical presentations of these patients vary, it is probable that the abdominal muscle disturbance and any concomitant intra-abdominal injuries are not evident.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical exploration, typically through a midline incision, aids in the identification of related injuries or those missed by the CT scan and allows for prompt treatment [ 10 ]. Individuals with minor defects may be treated without the use of prostheses, but those with major muscular abnormalities or those whose surgeries have been postponed will require mesh repair [ 8 ]. A number of studies have shown that primary TAWH repair increases both surgical site infection and recurrence rates up to 37.5% [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Traumatic Lateral Abdominal Wall Hernia: A Rare Manifestation of Blunt Trauma

Passos¹,

Katsaounis²,

Paraschou³

et al. 2023

Cureus

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Traumatic abdominal wall hernia (TAWH) following blunt injury is a rare clinical entity, induced by traumatic disruption of the abdominal wall's muscle and fascia, alongside abdominal organ herniation. A thorough clinical examination and a high level of suspicion are necessary for the diagnosis. We present the case of a 45-year-old individual who presented to the surgical outpatient clinic with a left lateral bulge in his belly caused by a mountaineering accident. After obtaining a thorough history of the mechanism of injury and clinical assessment, abdominal ultrasonography and computed tomography (CT) scan revealed a significant traumatic left lateral abdominal wall hernia. The patient subsequently underwent an open surgical mesh repair, followed by anatomical and functional restoration of the muscular deficit over the mesh, with an uneventful postoperative course. TAWH constitutes a diagnostic challenge, and in many cases remains untreated for long periods of time. Considering that TAWH occurs in less than 1% of all blunt abdominal trauma, many surgeons are unaware of this rare manifestation. Here we suggest that elective surgery with an open, tension-free polypropylene mesh repair appears to be an appropriate therapeutic option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Traumatic Lateral Abdominal Wall Hernia: A Rare Manifestation of Blunt Trauma

Passos¹,

Katsaounis²,

Paraschou³

et al. 2023

Cureus

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“…This patient's abdominal wall rupture was classified as a grade V abdominal wall injury due to complete rectus abdominis muscle disruption with herniation of abdominal contents. 5 Known risk factors for this condition include old age, weak abdominal muscles, and preexisting hernias. While rectus wall rupture with herniation is rare, it can be fatal if not treated immediately.…”

Section: Discussionmentioning

confidence: 99%

“…While rectus wall rupture with herniation is rare, it can be fatal if not treated immediately. 5 The presence of abdominal wall ecchymosis, otherwise known as a "seatbelt sign," after MVC is frequently associated with abdominal injuries. 5…”

Section: Discussionmentioning

confidence: 99%

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A Woman with Abdominal Pain After Lap-belt Trauma

Davis,

Shufflebarger,

Hubbs

et al. 2023

Clinical Practice and Cases in Emergency Medicine

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Case presentation: A 24-year-old female presented to the emergency department with diffuse abdominal pain after involvement as a restrained driver in a motor vehicle collision (MVC). Computed tomography of the abdomen revealed a traumatic abdominal wall hernia due to rectus wall rupture with complete bowel herniation.Discussion: A traumatic abdominal wall hernia is a rare complication of blunt abdominal trauma that is typically associated with injury from a motorcycle handlebar but is more commonly seen after a MVC. It is important to consider this diagnosis when evaluating patients with abdominal pain after blunt abdominal trauma from either of these mechanisms.

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