PDF(Pubmed)
Abstract：
UNASSIGNED: Traumatic abdominal wall hernia (TAWH) is an injury that occurs after an abdominal wall blunt trauma consisting of fasciomuscular rupture and does not present skin penetration. Documenting unique and rare clinical cases, such as traumatic hernia without skin penetration, enriches the medical literature and provides valuable information to identify innovative and optimised approaches for the treatment of similar cases in the future.
METHODS: 48-year-old female with no significant medical history presented to the emergency room after being directly hit by a 1200 kg vehicle while standing in the street. Clinical examination revealed a TAWH with total elevation and total loss of insertion of all abdominal wall muscles on the right side, and no involvement of the overlying skin secondary to the mechanism of trauma. The patient agreed to surgical management after being thoroughly informed about the procedure. Surgical exploration was performed with the patient in a lateral position, and the incision was made over the hernia sac. A monopolar electrocautery was used to expose the iliac crest and fully visualize the defect before drilling through the iliac crest. Soft macroporous polypropylene mesh repair was guided through the iliac crest and abdominal wall using a suture and secured with knots. The patient showed a satisfactory and favorable progress.
CONCLUSIONS: The present surgical technique is recommended for atypical cases of high-strength TAWH.
METHODS: 48-year-old female with no significant medical history presented to the emergency room after being directly hit by a 1200 kg vehicle while standing in the street. Clinical examination revealed a TAWH with total elevation and total loss of insertion of all abdominal wall muscles on the right side, and no involvement of the overlying skin secondary to the mechanism of trauma. The patient agreed to surgical management after being thoroughly informed about the procedure. Surgical exploration was performed with the patient in a lateral position, and the incision was made over the hernia sac. A monopolar electrocautery was used to expose the iliac crest and fully visualize the defect before drilling through the iliac crest. Soft macroporous polypropylene mesh repair was guided through the iliac crest and abdominal wall using a suture and secured with knots. The patient showed a satisfactory and favorable progress.
CONCLUSIONS: The present surgical technique is recommended for atypical cases of high-strength TAWH.
摘要：
■外伤性腹壁疝（TAWH）是在由筋膜破裂组成的腹壁钝性创伤之后发生的损伤，并且不存在皮肤穿透。记录独特和罕见的临床病例，比如没有皮肤渗透的创伤性疝气，丰富了医学文献，并提供了有价值的信息，以确定未来治疗类似病例的创新和优化方法。
方法：48岁无明显病史的女性站在街上被1200公斤重的车辆直接撞到急诊室。临床检查显示TAWH，右侧所有腹壁肌肉的完全抬高和完全丧失。并且没有继发于创伤机制的上覆皮肤的参与。患者在充分了解手术后同意手术治疗。患者侧卧位进行手术探查，切口是在疝囊上做的。使用单极电烙术暴露the骨，并在钻穿the骨之前完全可视化缺损。使用缝合线引导柔软的大孔聚丙烯网状物修复穿过the骨和腹壁，并用结固定。患者表现出令人满意和良好的进展。
结论：本手术技术推荐用于高强度TAWH的非典型病例。
方法：48岁无明显病史的女性站在街上被1200公斤重的车辆直接撞到急诊室。临床检查显示TAWH，右侧所有腹壁肌肉的完全抬高和完全丧失。并且没有继发于创伤机制的上覆皮肤的参与。患者在充分了解手术后同意手术治疗。患者侧卧位进行手术探查，切口是在疝囊上做的。使用单极电烙术暴露the骨，并在钻穿the骨之前完全可视化缺损。使用缝合线引导柔软的大孔聚丙烯网状物修复穿过the骨和腹壁，并用结固定。患者表现出令人满意和良好的进展。
结论：本手术技术推荐用于高强度TAWH的非典型病例。
