Traumatic abdominal wall hernia: A reappraisal

Kumar, Arvind; Hazrah, Priya; Bal, Sabyasachi; Seth, Amlesh; Parshad, Rajinder

doi:10.1007/s10029-003-0203-4

Cited by 35 publications

(33 citation statements)

References 34 publications

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“…Fewer than 35 cases of handlebar hernias have been reported in children [6][7][8] and less than 30 cases in adults [9][10][11]. Diagnostic laparoscopy has been used to identify injuries including traumatic hernias and other intraabdominal injuries before conversion to open repair, and laparoscopic repair of a traumatic jejunal perforation has been reported in hemodynamically stable pediatric patients [5,12,13].…”

Section: Discussionmentioning

confidence: 98%

Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury

Rowell

Chin

2011

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 98%

Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury

Rowell

Chin

2011

Journal of Pediatric Surgery

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“…1 Handlebar injury is the commonest reported cause. 7 In 1980, Dimyan et al applied the term handlebar hernia to describe a patient who was thrown against the handlebar of the motorcycle in a head-on collision with a motorcar. 2 A number of classification schemes for traumatic herniae based on size of defect, severity of injury and location, and mechanism of injury have been proposed.…”

Section: Discussionmentioning

confidence: 99%

“…8 Mesenteric and serosal tears are frequently identified in these patients. 1,5,7,[11][12][13] There are two possible mechanisms of blunt mesenteric injuries: (1) a crushing force applied to the bowel against the spine; and (2) shearing forces of the bowel and mesentery along the lines of attachment. 10 Obviously, a tangential shearing and tearing force applied to the abdominal wall and points of mesenteric fixation constitutes the common pathophysiology, rather than increased intraabdominal pressure.…”

Section: Discussionmentioning

confidence: 99%

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Handlebar hernia: A misleading term

Cheng

Liu

2005

Injury Extra

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“…Traumatic abdominal wall hernias are rare and represent only about one in 10,000 hernias. 65 They are commonly misclassified and should only be regarded as traumatic if they appear soon after the episode of trauma when there has been no skin penetration or no previous herniation at this site. There is often an association with a tear in the intestinal mesentery.…”

Section: Unusual Sitesmentioning

confidence: 99%

The Management of Incisional Hernia

Kingsnorth

2006

annals

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Ann R Coll Surg Engl 2006; 88: 252-260 252Medline and Embase were searched using the search terms 'hernia' and 'incisional' alone and in combination. Publications were selected mostly in the past 5 years, but did not exclude commonly reference and highly regarded older publications. The reference list of articles was also searched, identified by the search strategy and those selected that were relevant. Selected review articles and metaanalyses were included because they provide comprehensive overviews that may be beyond the scope of this article. OverviewThe introduction of prosthetic mesh revolutionised the treatment of groin hernia but, to date, has had little impact on the treatment of incisional hernia.1 The risk factors for the development of incisional hernia include obesity, diabetes, emergency surgery, postoperative wound dehiscence, smoking and postoperative wound infection. 2,3The risks of repairing an incisional hernia which should be explained to the patient when obtaining consent include seroma formation, wound infection, injury to intraabdominal structures and recurrence. 4 Major complications which can occur in repair of large incisional hernias include mesh infection and enterocutaneous fistula which may result in prolonged morbidity and require re-operation (Fig. 1). It is now accepted that only the smallest (less than 3 cm) incisional hernias should be repaired with primary tissue approximation with sutures and this topic will not be discussed further.5 Small incisional hernias with time develop into larger incisional hernias due to the continuous presence of intra-abdominal hydrostatic pressure of 15 cm of water, diaphragmatic contractions occurring with respiration, increases in abdominal pressure occurring with coughing and straining realising pressures of over 80 cm of water and myofascial retraction of the lateral muscles. As a result, the abdominal cavity contracts and the right of domicile for the herniated visceral mass is lost. 6 Due to several previous operations, many of these patients have poor-quality abdominal wall musculature which, coupled with multiple co-morbid medical problems, present a surgical and anaesthetic challenge.Surgeons appear to have a reluctance to operate on incisional hernias perhaps because of the poor general condition of the patients but perhaps also due to lack of knowledge of how to deal with the various defects occurring as a result of incisions of the anterior abdominal wall and the operative techniques required. For instance, although it is estimated that 13% of laparotomy incisions fail in The Netherlands, only 4% of patients undergoing a laparotomy will go through additional surgery to repair an incisional hernia.7 Suture repair is likely to produce results twice as bad as mesh repair and the current techniques that surgeons are using to repair incisional hernias with prosthetic mesh continue to yield recurrence rates of greater than 20%. Many thousand laparotomy incisions are created each year and the failure rate for closure of these abdominal wou...

show abstract

Traumatic abdominal wall hernia: A reappraisal

Cited by 35 publications

References 34 publications

Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury

Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury

Handlebar hernia: A misleading term

The Management of Incisional Hernia

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