PDF(Pubmed)
Abstract：
Traumatic abdominal wall hernia (TAWH) following blunt injury is a rare clinical entity, induced by traumatic disruption of the abdominal wall\'s muscle and fascia, alongside abdominal organ herniation. A thorough clinical examination and a high level of suspicion are necessary for the diagnosis. We present the case of a 45-year-old individual who presented to the surgical outpatient clinic with a left lateral bulge in his belly caused by a mountaineering accident. After obtaining a thorough history of the mechanism of injury and clinical assessment, abdominal ultrasonography and computed tomography (CT) scan revealed a significant traumatic left lateral abdominal wall hernia. The patient subsequently underwent an open surgical mesh repair, followed by anatomical and functional restoration of the muscular deficit over the mesh, with an uneventful postoperative course. TAWH constitutes a diagnostic challenge, and in many cases remains untreated for long periods of time. Considering that TAWH occurs in less than 1% of all blunt abdominal trauma, many surgeons are unaware of this rare manifestation. Here we suggest that elective surgery with an open, tension-free polypropylene mesh repair appears to be an appropriate therapeutic option.
摘要：
钝性损伤后的外伤性腹壁疝（TAWH）是一种罕见的临床实体，由腹壁肌肉和筋膜的创伤性破坏引起，伴随着腹部器官疝。彻底的临床检查和高度怀疑对于诊断是必要的。我们介绍了一个45岁的人的案例，该人因登山事故而向外科门诊就诊，腹部左侧凸起。在获得损伤机制和临床评估的全面病史后，腹部超声和计算机断层扫描（CT）扫描显示严重的外伤性左外侧腹壁疝。患者随后接受了开放式外科网片修复，然后是网状肌缺损的解剖和功能恢复，术后过程顺利。TAWH构成了诊断挑战，并且在许多情况下长时间不治疗。考虑到TAWH发生在所有钝性腹部创伤的不到1%，许多外科医生不知道这种罕见的表现。在这里，我们建议选择性手术，无张力聚丙烯网修复似乎是一种合适的治疗选择。
