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Ceballos Esparragón J, Dagnesses Fonseca J, Marín García J, Petrone P. Abdominal hernias secondary to non-penetrating trauma. A systematic review. Cir Esp 2024:S2173-5077(24)00169-8. [PMID: 39009304 DOI: 10.1016/j.cireng.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/20/2024] [Indexed: 07/17/2024]
Abstract
Traumatic abdominal wall hernia (TAWH) is a protrusion of contents through a defect in the abdominal wall as a consequence of a blunt injury. The objective of this review was to describe demographic and clinical aspects of this rare pathology, identifying the optimal moment for surgical intervention, evaluating the need to use mesh, and analyzing the effectiveness of surgical treatment. Thus, a systematic review using PubMed, Embase, and Scopus databases was carried out between January 2004 and March 2024. Computed tomography is the gold-standard imaging test for diagnosis. Open surgery is generally the preferred approach, particularly in emergencies. Acute TAWH can be treated by primary suture or mesh repair, depending on local conditions, while late cases usually require mesh.
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Affiliation(s)
| | - Javier Dagnesses Fonseca
- Department of Surgery, NYU Grossman Long Island School of Medicine, NYU Langone Hospital-Long Island, Mineola, New York, USA
| | - Jordi Marín García
- Department of Surgery, NYU Grossman Long Island School of Medicine, NYU Langone Hospital-Long Island, Mineola, New York, USA
| | - Patrizio Petrone
- Department of Surgery, NYU Grossman Long Island School of Medicine, NYU Langone Hospital-Long Island, Mineola, New York, USA.
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2
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Poppe M, Duarte CM, Fernandes S, Goulão J. Traumatic abdominal wall hernia in childhood: a bicycle handlebar injury. BMJ Case Rep 2024; 17:e260806. [PMID: 38782431 DOI: 10.1136/bcr-2024-260806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
A female patient in her middle childhood presented to the paediatric emergency room (ER) after a bicycle accident with an abdominal impact on the bicycle handlebar. On physical examination, a painful ecchymosis on the upper left quadrant was the only abnormal finding. Abdominal ultrasound showed no intra-abdominal lesions, and the patient was discharged home after 24 hours under monitoring. Nine days after the accident, she returned to the ER due to the emergence of an abdominal mass around the area of impact. Abdominal examination detected a tender non-fluctuating mass on the epigastric and left hypochondrium, and abdominal ultrasound revealed a muscle and aponeurosis disruption of the rectus muscle, with fat herniation and cytosteatonecrosis. A conservative approach was chosen, with ambulatory follow-up. One month after the accident, the patient was asymptomatic, no abdominal mass was palpable, and an abdominal CT showed a reduction of the muscle disruption and hernial content.
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Affiliation(s)
- Mariana Poppe
- Pediatrics, Hospital Beatriz Ângelo, Loures, Portugal
| | | | | | - João Goulão
- Pediatric Surgery, Hospital Beatriz Ângelo, Loures, Portugal
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Manasra MR, Farah RE, Abufara AA, AbuIrayyeh BM, Farah RE, Maraqa MA. Road Traffic Accident Traumatic Vehicle Seat Belt Abdominal Wall Hernia. Case Rep Surg 2024; 2024:4408980. [PMID: 39281804 PMCID: PMC11401737 DOI: 10.1155/2024/4408980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/21/2024] [Accepted: 01/29/2024] [Indexed: 09/18/2024] Open
Abstract
Traumatic abdominal wall hernia (TAWH) is a rare type of hernia with an incidence of about <1.5%, resulting from blunt abdominal trauma, which leads to an increase in the intra-abdominal pressure and rupture in the abdominal musculature and fascia with herniation of the abdominal organs into the defect. Most TAWH contained either a small bowel (69%) or a large bowel (36%), with 16% containing both. This condition is often not present as an isolated case, as 30% to 60% of the cases are accompanied by other intra-abdominal injuries. The typical manner of presentation is a tender subcutaneous swelling across the abdomen wall with overlaying bruising and ecchymosis. The radiological investigative modality of CT scan has the highest index of diagnosing accompanied intra-abdominal visceral injuries. We present a rare case of a 23-year-old male patient diagnosed with TAWH containing both small bowel and sigmoid colon associated with psoas hematoma caused by a seat belt postroad traffic accident (RTA).
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Affiliation(s)
- Mahmoud R Manasra
- Palestine Polytechnic University College of Medicine and Health Science, Hebron, Palestine, Israel
| | - Roua E Farah
- Palestine Polytechnic University College of Medicine and Health Science, Hebron, Palestine, Israel
| | - Arein A Abufara
- Palestine Polytechnic University College of Medicine and Health Science, Hebron, Palestine, Israel
| | - Bara M AbuIrayyeh
- Palestine Polytechnic University College of Medicine and Health Science, Hebron, Palestine, Israel
| | - Rahaf E Farah
- Palestine Polytechnic University College of Medicine and Health Science, Hebron, Palestine, Israel
| | - Mohammed A Maraqa
- Palestine Polytechnic University College of Medicine and Health Science, Hebron, Palestine, Israel
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Hefny AF, Al Qemzi AD, Hefny MA, Almarzooqi GA, Al Afari HST, Elbery AI. Acute Traumatic Lumbar Hernia: Report of Two Cases. J Emerg Trauma Shock 2023; 16:127-129. [PMID: 38025498 PMCID: PMC10661568 DOI: 10.4103/jets.jets_103_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2023] Open
Abstract
Acute traumatic lumbar hernia (ATLH) is rare in blunt trauma and can be overlooked due to the presence of multiple injuries following the trauma incidence. ATLH is usually found at the time of radiological examination or during surgical exploration. Awareness of the clinicians about the possibility of ATLH can enhance early diagnosis and reduce the occurrence of serious complications including bowel obstruction and strangulation. Herein, we present two cases of ATLH in which one of them was treated conservatively in the acute stage and the other patient was treated surgically. Conservative management can be adopted in the acute stage with the delayed repair of the hernia after resolving the muscles' contusion. However, early operative intervention is essential if conservative management failed or in the event of acute deterioration of the patient's condition.
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Affiliation(s)
- Ashraf F. Hefny
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University and Al Rahba Hospital, United Arab Emirates
| | - Ayesha D. Al Qemzi
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
| | - Mohamed A. Hefny
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghaya A. Almarzooqi
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
| | | | - Adel I Elbery
- Department of Radiology, Tawam Hospital, Al Ain, United Arab Emirates
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Abdelali M, Chaouch MA, Ben Jabra S, Saad J, Ben Mansour M, Chakroun S, Khouni Y, Aguir F, Achour A, Zrig A, Noomane F, Maatouk M. Post-traumatic lateral abdominal wall hernia: a case report. Ann Med Surg (Lond) 2023; 85:1194-1196. [PMID: 37113951 PMCID: PMC10129220 DOI: 10.1097/ms9.0000000000000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
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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Affiliation(s)
| | - Mohamed Ali Chaouch
- Visceral and Digestive Surgery
- Corresponding Author. Address: Universite de Monastir, Ksar Hellal, Monastir, Tunisia. Tel: +216 2620 5105; fax: +21673124578. E-mail address: (M. A. Chaouch)
| | | | | | - Maha Ben Mansour
- Intensive Care, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - Sawsen Chakroun
- Intensive Care, Monastir University Hospital, University of Monastir, Monastir, Tunisia
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Chaudhary S, Luck T, Cole J. Traumatic abdominal wall hernia in a patient with diastasis recti. ANZ J Surg 2022; 92:2739-2741. [PMID: 35233879 DOI: 10.1111/ans.17580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Shreyas Chaudhary
- Department of Surgery, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Tara Luck
- Department of Surgery, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
| | - Jessie Cole
- Department of Surgery, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
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Pothiawala S, Balasubramaniam S, Taib M, Bhagvan S. Traumatic abdominal wall hernia: a rare and often missed diagnosis in blunt trauma. World J Emerg Med 2022; 13:492-494. [PMID: 36636561 PMCID: PMC9807386 DOI: 10.5847/wjem.j.1920-8642.2022.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/26/2022] [Indexed: 01/16/2023] Open
Affiliation(s)
- Sohil Pothiawala
- Trauma Service, Auckland City Hospital, Auckland 1023, New Zealand,Corresponding Author: Sohil Pothiawala,
| | | | - Mujeeb Taib
- Trauma Service, Auckland City Hospital, Auckland 1023, New Zealand
| | - Savitha Bhagvan
- Trauma Service, Auckland City Hospital, Auckland 1023, New Zealand
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Jae Gal M, Kim JC. Small Bowel Hernia due to a Blunt Pelvic Injury. JOURNAL OF TRAUMA AND INJURY 2021. [DOI: 10.20408/jti.2020.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
<p>A 91-year-old female presented to Chonnam National University Hospital Regional Trauma Center with a lateral compression type III fracture of the pelvis. She was managed non-operatively for a week in the intensive care unit under close observation and had an emergency operation due to delayed onset of an acute obstructed direct inguinal hernia. Traumatic abdominal wall hernias are rare. However, trauma surgeons should always be aware of the possibility of such injuries because of their critical consequences.</p>
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Imran M, Srivastava V, Pandey V. Masquerades of a Traumatic Spigelian Hernia: Lessons Learnt. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02974-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Skelhorne-Gross G, Nantais J, Ditkofsky N, Gomez D. Massive traumatic abdominal wall hernia with significant tissue loss: challenges in management. BMJ Case Rep 2021; 14:14/5/e242609. [PMID: 33952570 PMCID: PMC8103389 DOI: 10.1136/bcr-2021-242609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 41-year-old woman presented to our trauma centre following a high-speed motor vehicle collision with a seatbelt pattern of injury resulting in extensive rupture of her abdominal wall musculature and associated hollow viscus injuries. The abdominal wall had vertical separation between transected rectus, bilateral transverse abdominis and oblique muscles allowing evisceration of small and large bowel into the flanks without skin rupture. Intraoperatively, extensive liquefaction and tissue loss of the abdominal wall was found with significant retraction of the remaining musculature. Initial operative management focused on repair of concomitant intra-abdominal injuries with definitive repair performed in delayed, preplanned stages including bridging with absorbable mesh and placement of an overlying split-thickness skin graft. The patient was discharged from hospital and underwent extensive rehabilitation. One year later, the abdominal wall was definitively repaired with components separation and biological mesh underlay. This stepwise repair process provided her with a robust and enduring abdominal wall reconstruction.
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Affiliation(s)
- Graham Skelhorne-Gross
- Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jordan Nantais
- Department of Surgery, Division of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Noah Ditkofsky
- Department of Radiology, Division of Emergency, Trauma and Acute Care Imaging, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - David Gomez
- Department of Surgery, Division of General Surgery, University of Toronto, Unity Health Toronto, Toronto, Ontario, Canada
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Delaune L, Steinmetz S, Heutschi-Öztürk H, Borens O. Traumatic abdominal wall hernias: disruptions of the abdominal wall muscles associated to pelvic bone fractures illustrated by two case reports. BMC Surg 2020; 20:253. [PMID: 33109131 PMCID: PMC7590667 DOI: 10.1186/s12893-020-00909-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blunt abdominal traumas are often associated with intra-abdominal injuries and pelvic fractures. Traumatic abdominal wall hernias due to disruption of the abdominal wall muscles may be overlooked. Delayed diagnosis can lead to hernia related complications. CASE PRESENTATION We present two cases of high kinetic trauma with pelvic fractures and acute traumatic abdominal wall herniation. Both of these cases suffered from a delayed diagnosis and needed surgery to treat the symptomatic herniation. CONCLUSION Clinical reassessment and appropriate medical imaging are mandatory in patients with high kinetic abdominal blunt traumas and associated pelvic fracture, in order to prevent delayed diagnosis and possible complications.
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Affiliation(s)
- Leïlani Delaune
- Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Sylvain Steinmetz
- Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
| | | | - Olivier Borens
- Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
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12
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Kim H, Kim JH, Kim GH, Sun HW, Park CI, Park SJ, Lee CK, Kim S. Blunt Transection of the Entire Anterolateral Abdominal Wall Musculature Following Seatbelt-Related Injury. JOURNAL OF TRAUMA AND INJURY 2020. [DOI: 10.20408/jti.2020.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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13
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Kauffmann P, Ugé S, Baicry F, Guerrero J, Le Borgne P. [Handlebar in the stomach]. Presse Med 2019; 48:1355-1357. [PMID: 31753451 DOI: 10.1016/j.lpm.2019.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/18/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Philippe Kauffmann
- Hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, service d'accueil des urgences, 1, avenue Molière, 67098 Strasbourg, France
| | - Sarah Ugé
- Hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, service d'accueil des urgences, 1, avenue Molière, 67098 Strasbourg, France
| | - Florent Baicry
- Hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, service d'accueil des urgences, 1, avenue Molière, 67098 Strasbourg, France
| | - Javier Guerrero
- Hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, service d'accueil des urgences, 1, avenue Molière, 67098 Strasbourg, France
| | - Pierrick Le Borgne
- Hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, service d'accueil des urgences, 1, avenue Molière, 67098 Strasbourg, France; Université de Strasbourg, faculté de médecine, UMR 1260, rue Kirschleger, 67000 Strasbourg, France.
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