Traumatic Abdominal Wall Hernia: Epidemiology and Clinical Implications

Abstract

First, the mechanism of injury should be considered when deciding if a patient with a TAWH needs an urgent laparotomy. Clinically apparent anterior TAWHs appear to have a high rate of associated injuries requiring urgent laparotomy. Finally, occult TAWHs diagnosed only by computed tomography may not require urgent laparotomy or hernia repair.

Laparoscopic repair of traumatic abdominal wall hernia from handlebar injury

“…The presence of an external skin abrasion, or handlebar sign, or focal abdominal tenderness with guarding and possibly a palpable hernia defect may signal the presence of a traumatic abdominal wall hernia. However, occult hernias may also occur and are usually detected only by abdominal CT scan [1]. The term handlebar hernia was coined by Dimyan et al [4] in 1980.…”

“…Traumatic abdominal wall hernias, although uncommon, are seen in approximately 1% of the patients with blunt trauma managed at a major trauma center [1]. These traumatic hernias can result from both high energy (ie, motor vehicle crash with deceleration) and low energy (ie, handlebar injury) mechanisms [2].…”

Subtle mesenteric avulsion in a traumatic abdominal wall hernia: A case report

“…In an epidemiological study at a regional trauma center in Canada, TAWH secondary to motor vehicle collisions were significantly more likely to require emergency laparotomy than other mechanisms. 5,6 The "seat belt syndrome", a collective term first used by Aiken in 1963, refers to intra-abdominal and pelvic injuries which are sustained after high impact blunt insults. Avulsion and tears occur at the axis of fixation of an otherwise mobile viscera, where as perforation occurs at the area of a hollow viscus which overlies a fixed bony structure.…”

Cirugía Hoy: Convergencia de Centros Universitarios y Sociedades Científicas

“…La TAC es el examen diagnóstico más sensible y tiene la ventaja de informar la presencia de lesiones intraabdominales asociadas, las que pueden encontrarse en un 67% de los casos 4 . Su definición, clasificación y manejo aun es controversial, principalmente en cuanto al momento de su resolución quirúrgica (urgencia o diferida) 5 y técnica empleada.…”