Complete abdominal wall disruption with herniation following blunt injury: case report and review of the literature

Suhardja, Thomas Surya, Atalla, Mohamed Anwar, and Rozen, Warren Matthew (2015) Complete abdominal wall disruption with herniation following blunt injury: case report and review of the literature. International Surgery, 100 (3). pp. 531-539.

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Abstract

Acute traumatic abdominal wall hernia (TAWH) is a rare type of hernia that occurs after a low- or high-velocity impact of the abdominal wall against a blunt object. With few cases reported, a consensus in diagnosis and management has not been established in the literature. A systematic review of the literature for adult cases of traumatic abdominal wall hernia due to blunt abdominal trauma was undertaken. All original articles were reviewed and data were compiled and tabulated qualitatively. Diagnostic imaging modalities and their reported description of the abdominal wall hernia were detailed correlated with the laparotomy findings. We also report a case of TAWH following blunt abdominal trauma, and describe integration of this management into clinical practice. Fifty-five cases of adult TAWH were found in the English literature. Most hernias contained either small bowel (69%) or large bowel (36%), with 16% of TAWH containing both. Concurrent intra-abdominal injuries were seen in 60% of cases, with an almost equal number of associated bowel (44%) and solid organ (35%) injuries. Twenty percent of diagnosis of TAWH was delayed, ranging from 2 days to 9 years. While TAWH is uncommon, a high index of suspicion is required in patients who present with blunt abdominal trauma. A staging system for TAWH can facilitate appropriate management priorities and treatment. CT scanning is crucial in the diagnosis of TAWH, and aids in definitive management of these patients. The literature supports immediate surgical exploration for most TAWH.

Item ID: 41942
Item Type: Article (Research - C1)
ISSN: 0020-8868
Keywords: abdomen, computed tomography, CT, trauma, laparotomy
Date Deposited: 08 Dec 2015 18:31
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 90%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110320 Radiology and Organ Imaging @ 10%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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