Traumatic Spigelian Hernia Following Blunt Abdominal Trauma

Abstract

Traumatic abdominal wall hernia (TAWH) is a rare form of hernia occurring after blunt trauma to the abdomen. Traumatic Spigelian hernia is an uncommon subtype sporadically described in the literature. It is an anterior abdominal wall defect occurring along the Spigelian aponeurosis bounded laterally by the semilunar line and medially by the rectus abdominis muscle. Imaging with CT is the investigation of choice. The surgeon has a variety of treatment options ranging from the traditional midline laparotomy to laparoscopic repair with or without the use of mesh. Conservative treatment has also been advocated as a safe and feasible option in select cases. Described here is a case of traumatic Spigelian hernia following blunt abdominal trauma caused by a motorcycle handlebar in a 17-year-old male.

An Unusual Mountain Biking Injury: Case Records of the Massachusetts General Hospital Wilderness Medicine Fellowship

“…Handlebar injuries can include pancreatic injuries, traumatic abdominal wall hernias, duodenal hematoma, splenic and liver injuries, renal injuries, and rarely, vascular injuries. [4][5][6][7][8][9] Handlebar injuries are less common in adults, presumably because of well-developed abdominal wall musculature as well as the reduced likelihood of riding recklessly, in comparison to children and adolescents. 10 At this point, the patient requires evacuation and further evaluation.…”