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

Ballard, David H.; Kaskas, Nadine M.; Jahromi, Alireza Hamidian; Skweres, Justin; Youssef, Asser M.

doi:10.1016/j.ijscr.2014.11.036

Cited by 8 publications

(16 citation statements)

References 11 publications

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“…Associated intra-abdominal injuries such as bowel perforation, splenic rupture, liver lacerations or pelvic fractures are frequent, the percentages varying from 30 % to 60 %. 3,4,6 There is a possibility for the patient to become symptomatic after a longer period following the blunt abdominal trauma while only presenting mild discomfort at the site of injury. 2 The location of the hernia might be linked to a higher or lower risk of concurrent visceral injuries.…”

Section: Resultsmentioning

confidence: 99%

“…4 Management is generally based on the mechanism and force of the injury, nature and severity of other lesions, size of the hernia and the general condition of the patient. 6 TAWHs can be classified into three main types. The first type occurs in high-energy injuries, the fascial defect is large and concurrent intra-abdominal lesions are common.…”

Section: Resultsmentioning

confidence: 99%

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Traumatic abdominal wall hernias: Classification, diagnosis and management

Mincu¹,

Mușat²,

Ion³

et al. 2020

Scripta Medica

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Traumatic abdominal wall hernias (TAWHs) are uncommon health conditions that involve a disruption of the muscular layers after a blunt abdominal injury. A consensus in the management of TAWHs has not been established, owing to the scarce number of reported cases. These hernias can occur under a broad array of clinical presentations, from stable and asymptomatic patients to emergency situations with associated intra-abdominal injuries. The aetiology of TAWHs is diverse and can occur at all ages, however it is more likely to be reported in children and elderly patients. Clinical findings must be correlated with a CT scan, which will confirm the diagnosis. Early diagnosis and treatment were found to be associated with a lower risk of complications and mesh use during the surgical repair is an efficient mean of reducing recurrences after the surgical repair. However, the timing of repair and surgical solution still depends on the patient's condition.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Traumatic abdominal wall hernias: Classification, diagnosis and management

Mincu¹,

Mușat²,

Ion³

et al. 2020

Scripta Medica

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“…there are no reported CT findings of TAWH that help to distinguish it from a preexisting hernia (44), experience at our institution suggests that the presence of fat stranding is the most helpful feature to indicate acute trauma (Fig 12). Fat stranding, fluid in the hernia sac, and findings suggestive of compromised bowel (such as wall thickening, hypoenhancement, and vessel engorgement) may be suggestive of acute trauma to either an acute or preexisting hernia (52).…”

Section: Pearls and Pitfallsmentioning

confidence: 92%

“…Seat belts have since been upgraded to a three-point restraint, which results in fewer associated spinal injuries; and thus a new "seat belt lethal triad" has been described, which is made up of TAWH, hollow viscus injury, and abdominal vascular injury (4,41). Although injuries to the abdominal aorta are uncommon, occurring in less than 1% of blunt trauma cases, the mechanism for injury is the same as that causing TAWH; and thus a high index of suspicion should be maintained (44,45).…”

Section: Mechanism Of Injurymentioning

confidence: 99%

“…Controversy exists about whether to use mesh in the acute setting; although mesh decreases the risk of recurrent hernia, the risk of infection is increased when mesh is used in the emergent setting (36,44,50,51) (Fig 15). Hollow viscus injury remains a contraindication to the use of permanent mesh in the acute setting because of the increased risk of infection, although newer biologic meshes are being used more frequently in these cases, with better success (51).…”

Section: Treatmentmentioning

confidence: 99%

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Don’t Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma

et al. 2017

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Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. RSNA, 2017.

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