Traumatic abdominal wall hernia : Tangential radiography-aided diagnosis
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Abstract
Background: Traumatic abdominal wall hernia is uncommon and defined as bowel loop or a viscus through the defect in disruption of abdominal wall muscles in the abdominal wall at the site of injury. Published reports suggest the diagnosis by history, physical examination and confirmed diagnosis by Ultrasound and Computed tomography scan.
Objective: Tangential radiography is a simple method to confirmed diagnosis revealed dilated bowel with a round pocket gas-lying in the anterior abdominal wall.
Setting: Department of Surgery, Sisaket hospital.
Research design: Case reports and review of the literature.
Patients: Four cases of Traumatic abdominal wall hernia.
Results: During 10 year-period at Sisaket hospital (1995-2005), there were four cases of Traumatic abdominal wall hernia that had been struck to the abdominal wall by motorcycle-handlebar. Physical examination revealed abdominal wall tenderness, ecchymosis and bulging at the site of injury. Supine plain abdomen revealed dilated small bowel. Tangential radiographs revealed dilated bowel with a round pocket of gas-lying in the anterior abdominal wall, confirmed the presence of a hernia. One-four patients, motor vehicle collision was identified intra-abdominal organ injury. Surgical explorations were done in all patients with primary repair of all tissue layers of the abdominal wall and small bowel was repaired in one case. All four cases had no surgical complications.
Conclusion: Traumatic abdominal wall hernia, especially handlebar injury can be diagnosed by history, physical examination and radiographs. A tangential projection of the injury area revealed small bowel with a separated small gas-filled area, containing air-fluid level lying in the anterior abdominal wall suggesting the diagnosis of an abdominal wall hernia. This is a simple way to confirmed diagnosis.
Key words: Traumatic abdominal wall hernia; Handlebar hernia; Handlebar injury
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References
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