Abstract：
Traumatic abdominal wall hernia (TAWH) is a rare consequence of blunt abdominal trauma, usually in the setting of multitrauma, with little consensus or guidelines for management. We present a case series of patients with traumatic herniae over a 9-year period and a suggested management algorithm.
Retrospective review of all patients with TAWH from 1st January 2011 to 31st December 2019 at a Level 1 adult Major Trauma Centre. Clinical presentation, surgical intervention and complications and recurrence were analysed.
Forty-seven patients were found to have TAWH, 0.5% of all major trauma admissions. Thirty (63.8%) were repaired, 12 acutely, 11 semi-acute and 7 delayed. All but 1 (fall>3 m) were transport associated, with a median Injury Severity Score (ISS) of 29. Follow-up data for operative cases were available for all but one (97%). Seven (23.3%) cases had a recurrence, more common in the acute repair group (33.3%) compared to semi-acute (18.2%), and elective group (14.3%).
TAWH is a rare but potentially serious consequence of blunt abdominal trauma. This series has favoured earlier repair for anterior TAWH, or all those undergoing a laparotomy for other reasons, and elective repair for lumbar or lateral TAWH that do not require a laparotomy for other conditions. We present our preferred algorithm for management, accepting that there are many available strategies in this heterogeneous group of injuries. Loss of follow up and recurrence are a concern, and clinicians are encouraged to develop processes to ensure that TAWH are not a \'forgotten hernia\'.
Retrospective review of all patients with TAWH from 1st January 2011 to 31st December 2019 at a Level 1 adult Major Trauma Centre. Clinical presentation, surgical intervention and complications and recurrence were analysed.
Forty-seven patients were found to have TAWH, 0.5% of all major trauma admissions. Thirty (63.8%) were repaired, 12 acutely, 11 semi-acute and 7 delayed. All but 1 (fall>3 m) were transport associated, with a median Injury Severity Score (ISS) of 29. Follow-up data for operative cases were available for all but one (97%). Seven (23.3%) cases had a recurrence, more common in the acute repair group (33.3%) compared to semi-acute (18.2%), and elective group (14.3%).
TAWH is a rare but potentially serious consequence of blunt abdominal trauma. This series has favoured earlier repair for anterior TAWH, or all those undergoing a laparotomy for other reasons, and elective repair for lumbar or lateral TAWH that do not require a laparotomy for other conditions. We present our preferred algorithm for management, accepting that there are many available strategies in this heterogeneous group of injuries. Loss of follow up and recurrence are a concern, and clinicians are encouraged to develop processes to ensure that TAWH are not a \'forgotten hernia\'.
摘要：
外伤性腹壁疝（TAWH）是腹部钝性外伤的罕见后果，通常在多发性创伤的背景下，几乎没有共识或管理指南。我们介绍了一系列9年的创伤性疝气患者病例，并提出了建议的管理算法。
回顾性审查2011年1月1日至2019年12月31日在1级成人重大创伤中心的所有TAWH患者。临床表现,分析手术干预、并发症及复发情况。
47名患者被发现患有TAWH,占所有重大创伤入院人数的0.5%。修复了30件(63.8%),12敏锐地，11个半急性，7个延迟。除1个(下降>3米)外，所有都与运输相关，平均伤害严重程度评分（ISS）为29。除1例（97％）外，所有病例均可获得手术病例的随访数据。7例(23.3%)复发,与半急性（18.2%）相比，急性修复组（33.3%）更常见，和选修组(14.3%)。
TAWH是腹部闭合性创伤的罕见但潜在的严重后果。这个系列有利于早期修复前TAWH，或所有因其他原因进行剖腹手术的人，以及腰椎或外侧TAWH的选择性修复，不需要对其他情况进行剖腹手术。我们提出了我们首选的管理算法，接受在这个异质性损伤组中有许多可用的策略。失去随访和复发是一个令人担忧的问题，鼓励临床医生制定流程，以确保TAWH不是“被遗忘的疝气”。
回顾性审查2011年1月1日至2019年12月31日在1级成人重大创伤中心的所有TAWH患者。临床表现,分析手术干预、并发症及复发情况。
47名患者被发现患有TAWH,占所有重大创伤入院人数的0.5%。修复了30件(63.8%),12敏锐地，11个半急性，7个延迟。除1个(下降>3米)外，所有都与运输相关，平均伤害严重程度评分（ISS）为29。除1例（97％）外，所有病例均可获得手术病例的随访数据。7例(23.3%)复发,与半急性（18.2%）相比，急性修复组（33.3%）更常见，和选修组(14.3%)。
TAWH是腹部闭合性创伤的罕见但潜在的严重后果。这个系列有利于早期修复前TAWH，或所有因其他原因进行剖腹手术的人，以及腰椎或外侧TAWH的选择性修复，不需要对其他情况进行剖腹手术。我们提出了我们首选的管理算法，接受在这个异质性损伤组中有许多可用的策略。失去随访和复发是一个令人担忧的问题，鼓励临床医生制定流程，以确保TAWH不是“被遗忘的疝气”。
