Blunt Traumatic Abdominal Wall Hernias: A Surgeon’s Dilemma

Pardhan, Amyn; Mazahir, Samia; Rao, Sudhakar; Weber, Dieter

doi:10.1007/s00268-015-3256-5

Cited by 28 publications

(40 citation statements)

References 20 publications

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“…It is our feeling that this will result in the effective management of the hernia while also improving patient comfort and shortening time of disability. Clearly, this is an area that could benefit from further study and we would lend our voice to that of other authors suggesting that a larger prospective study with an appropriate follow-up period is the best way to generate reliable treatment algorithms [ 9 ] These types of studies should include early laparoscopic repair, as we believe it is feasible and safe.…”

Section: Discussionmentioning

confidence: 99%

The early laparoscopic repair of a traumatic lumbar hernia: safe and successful

Kaminski

Diamond

2017

Journal of Surgical Case Reports

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Abdominal wall hernias are a rare but important consequence of blunt trauma. The optimal timing and the method of repair are not well described in the current surgical literature. Advances in laparoscopic techniques have offered new options for treatment of this problem. We describe the case of a 43-year-old man who suffered a blunt traumatic lumbar hernia. He was taken to the operating room during his initial hospitalization where a laparoscopic repair was performed with the additional implantation of prosthetic mesh. His post-operative course was uneventful. In selected cases, early operative repair may be appropriate and result in improved outcomes.

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Section: Discussionmentioning

confidence: 99%

The early laparoscopic repair of a traumatic lumbar hernia: safe and successful

Kaminski

Diamond

2017

Journal of Surgical Case Reports

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“…Traumatic flank hernias are rare but potentially difficult problems, with a reported recurrence rate of 7%–26%. 29 , 35 , 56 These hernias can be quite bothersome to patients, causing a significant degree of bulging and discomfort. Traditional open repair techniques have consisted of primary repair or more commonly repair with giant mesh reinforcement.…”

Section: Discussionmentioning

confidence: 99%

“…In any patient with an acute traumatic abdominal wall hernia, there must be a high suspicion for associated intra-abdominal injuries, 8 , 11 , 27 – 33 as well as pelvic fractures, 27 , 34 , 35 as a high force is required to cause this herniation. These high-energy injuries have a high incidence of associated operative intra-abdominal injuries and thus the risk of a contaminated field.…”

Section: Introductionmentioning

confidence: 99%

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

Kearney

Dumanian

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Traumatic abdominal wall hernias are rare injuries resulting from blunt abdominal trauma. Traditional approaches have included both open and laparoscopic approaches, with placement of large meshes with giant overlaps. Perhaps the most technically difficult aspect of these repairs is fixating the abdominal wall to the iliac crest. The senior author has developed a method of repair using 2-cm strips of mesh. In this article, we present a description of 4 patients treated with this technique. Methods: We included 4 adult patients who underwent traumatic flank hernia repairs by the senior author. We excluded incisional hernias and patients who received a planar sheet of mesh. Demographics and outcomes collected included length of stay, follow-up time, and complications. Results: The average age was 38.5 years. Three hernias were due to motor vehicle collision injuries, and 1 was a crush injury at work. No planar meshes or bone anchors were used. No patients required component separation. There were no instances of surgical site infection, hematoma, or wound breakdown. All repairs were intact at the time of last follow-up (average, 24.3 months; range, 4–48.7 months). Conclusions: Traumatic flank hernias are rare injuries that can be difficult to address. Here, we describe a technique of primary repair with mesh strips that distribute the forces of repair across a greater surface area than can be achieved with sutures. Placing drill holes through the iliac crest avoids the cost and complexity of suture anchors.

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“…Alternatively, the seatbelt may cause a sudden increase in intra-abdominal pressure triggering rupture of the abdominal wall [9]. A seatbelt is often worn incorrectly by the obese [10]. Thus, a high index of suspicion for TAWH is required for overweight and obese patients, particularly those involved in motor vehicle crashes while wearing seatbelts.…”

Section: Discussionmentioning

confidence: 99%

Blunt Transection of the Entire Anterolateral Abdominal Wall Musculature Following Seatbelt-Related Injury

Kim

et al. 2020

J Trauma Inj

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Traumatic abdominal wall hernias (TAWHs) are uncommon and the incidence of this, which is rarely encountered in clinical practice, has been estimated at 1%. Furthermore, blunt transection of the entire abdominal wall musculature caused by seatbelt is a very rare complication. We report a case of adult with a complete disruption of the entire anterolateral abdominal wall muscle following the seatbelt injury. A 32-year-old male was wearing a seat belt in a high speed motor vehicle collision. Abdominal computed tomography (CT) scan revealed the complete disruption of bilateral abdominal wall musculatures including TAWH without visceral injury. However, injuries of small bowel and sigmoid colon were observed in the intra-operative field. The patient underwent the repair by primary closure of the defect with absorbable monofilament sutures. This case suggests that especially in TAWH patients, even if a CT scan is normal, clinicians should keep the possibility of bowel injury in mind, and choose a treatment based on the clinical findings.

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Blunt Traumatic Abdominal Wall Hernias: A Surgeon’s Dilemma

Cited by 28 publications

References 20 publications

The early laparoscopic repair of a traumatic lumbar hernia: safe and successful

The early laparoscopic repair of a traumatic lumbar hernia: safe and successful

Simplified Repair of Traumatic Iliac Crest Flank Hernias with Mesh Strips

Blunt Transection of the Entire Anterolateral Abdominal Wall Musculature Following Seatbelt-Related Injury

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