Post-traumatic lateral abdominal wall hernia: a case report

• Published in: Annals of medicine and surgery Vol. 85; no. 4; pp. 1194 - 1196
• Main Authors: Abdelali, Mabrouk, Chaouch, Mohamed Ali, Ben Jabra, Sadok, Saad, Jamal, Ben Mansour, Maha, Chakroun, Sawsen, Khouni, Yasmine, Aguir, Fadwa, Achour, Asma, Zrig, Ahmed, Noomane, Faouzi, Maatouk, Mezri
• Format: Journal Article
• Language: English
• Published: England Lippincott Williams & Wilkins 01-04-2023
• Subjects: Case Reports; trauma; computed tomography scan; case report; hernia; traumatic abdominal wall hernia
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1097/MS9.0000000000000454

Traumatic abdominal wall hernia (TAWH) also known as blunt abdominal TAWH is uncommon. The clinical diagnosis is difficult. The authors present a case report of posthigh-energy abdominal blunt trauma causing a TAWH.
A 36-year-women, with unremarkable past medical history, was presented to the Emergency Department after a stuck in high-speed two automobiles. She was hemodynamic, respiratory, and neurologically stable. The BMI was 36 kg/m². The abdomen was not distended with an ecchymotic lesion on the right flank. The thoracic abdominal and pelvic computed tomography (CT) scan revealed a rupture in the lateral abdominal wall muscles with a TAWH in the location of the skin ecchymoses. There was no visceral lesion or intraperitoneal fluid. A conservative treatment was indicated. The follow-up was uneventful, with hematoma resorption and no cellulitis or abscess. The patient was discharged after 1 week. An abdominal repair will be planned using a mesh.
TAWH is a rare entity. The best imaging modality for diagnosis is the CT scan allowing classification of the hernia and a screen for other injuries. The presence of an isolated TAWH must lower the threshold to closely monitor or to operatively explore, given the high rate of false-negative findings at imaging features.
TAWH should be suspected behind any blunt abdominal trauma with high energy. CT scan and ultrasound were helpful for diagnosis and the only curative treatment is surgery to avoid complications.