Abstract :
Traumatic abdominal wall hernia, a rare entity that occurs as a result of blunt abdominal trauma. Most cases are in children, which occurs due to bicycle handlebar injuries. While in adults, the presentation varies, making the diagnosis quite difficult. In this study, we present four cases with varying presentations and management. A 36-year-old female was presented with a motorcycle handle trauma in left lower abdomen. She had a bruising over the skin in left iliac fossa with tenderness. contrast-enhanced computed tomography (CECT) of abdomen showed an 8/4-cm defect in the aponeurotic part of the external oblique muscle, with protrusion of omentum and jejunum. She underwent mesh repair for the defect and recovered well. A 48-year-old, milkman male presented with history of motorcycle handle trauma in left lower abdomen. He had a central abdominal parietal wall swelling and bruising. CECT abdomen revealed a 6/4-cm defect in the anterior abdominal wall muscles with protrusion of sigmoid colon loop. After an onlay prolene mesh repair for the defect closure, he was discharged. A 65-year-old female presented with lower abdominal pain, distention, and vomiting following bull horn injury. He had distended abdomen and tenderness in right iliac fossa. CECT abdomen showed a 2/3 cm defect in the aponeurotic part of the external oblique muscle, with protrusion of ileal loop. After a primary repair of an abdominal wall defect and an exploratory laparotomy, he was discharged. A 16-year-old, schoolboy presented with history of bicycle handle injury in right lower abdomen. Abdominal examination showed tenderness in right lumbar region. CECT abdomen showed a 2/2-cm defect in the anterior abdominal wall muscles with protrusion of omentum. After an exploratory laparotomy, he was discharged. Traumatic abdominal wall hernia presents a diagnostic as well as a therapeutic challenge. CECT is the reliable aid in the diagnoses before the operative repair is quite safe and efficacious. Management of each case is governed by a variety of factors, emphasizing the importance of a patient-specific, case-by-case management strategy..
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