Traumatic abdominal wall hernia describes traumatic disruption of musculature and fascia of anterior abdominal wall without skin penetration.
Abdominal skin ecchymosis or abrasions may be seen.
Traumatic abdominal wall hernia is caused by blunt trauma to the abdomen. In adults, it usually results from road traffic accidents, while in children it occurs following an injury from the bicycle handle bar.
In these injuries, a sudden increase in intraabdominal pressure due to the direct impact results in abdominal wall disruption that is insufficient to penetrate skin but strong enough to disrupt muscle and fascia.
There is often no evidence of a prior hernia defect at the site of injury.
Bowel, mesenteric, pancreatic and other visceral injuries are very common.
Disruption of all layers of muscle and fascia yet elastic skin layer remains intact.
Although the size of the tear may vary significantly, some classically described locations include:
- region of iliac crest in seat belt injury (site of lap and shoulder strap junction)
- focal, lower abdomen, lateral to the rectus sheath, inguinal region
- larger diffuse abdominal wall defects sustained in motor car accidents
- rarely in the retroperitoneum
Treatment and prognosis
Surgical correction is often necessary.
Other types of abdominal wall hernia.
- 1. Michael P. Federle Siva P. Raman. Diagnostic Imaging: Gastrointestinal, 3e 3rd Edition
- 2. Singal R, Dalal U, Dalal AK, Attri AK, Gupta R, Gupta A, Naredi B, Kenwar DB, Gupta S. Traumatic anterior abdominal wall hernia: A report of three rare cases. Journal of emergencies, trauma, and shock. 4 (1): 142-5. doi:10.4103/0974-2700.76832 - Pubmed
- 3. Yadav S, Jain SK, Arora JK, Sharma P, Sharma A, Bhagwan J, Goyal K, Sahoo BS. Traumatic abdominal wall hernia: Delayed repair: Advantageous or taxing. International journal of surgery case reports. 4 (1): 36-9. doi:10.1016/j.ijscr.2012.10.004 - Pubmed
- 4. Agarwal N, Kumar S, Joshi MK, Sharma MS. Traumatic abdominal wall hernia in two adults: a case series. Journal of medical case reports. 3: 7324. doi:10.4076/1752-1947-3-7324 - Pubmed