Laura Cebolla Rojas (Madrid / ES), Carlos Morales García (Madrid / ES), Melanie Morote González (Madrid / ES), Maria Galindo Alins (Madrid / ES), Carlota Perez Carpio (Madrid / ES), María Mercedes Sanz Sánchez (Madrid / ES), María Dolores Pérez Díaz (Madrid / ES), Cristina Rey Valcárcel (Madrid / ES), Fernando Turégano Fuentes (Madrid / ES)
Abstract text (incl. references and figure legends)
Introduction: Traumatic abdominal wall hernias (TAWH) are caused by the disruption of the musculature and fascial structures after a blunt high energy trauma without skin rupture. Because of the its low incidence, diagnosis is difficult and treatment complex and no clear consensus exists on the best moment for surgery. The aim of this study was to analyze our small case series
Material and methods: Descriptive and retrospective study from severe trauma database in our center. Patients with a TAWH were studied over a period of 20 years (2001-2020). An analysis of demographic data, mechanisms of injury, type and location of TAWH, associated lesions and treatment were performed.
Results: During the study period, 1.226 patients with severe blunt abdominal trauma were included. We identified 6 patients with TAWH, aged between 20-64 years. The injury mechanism was traffic collision, except for one case of bullhorn trauma. The diagnosis was made in 3 patients during the clinical evaluation, and the others were radiological or surgical findings. TAWH were mostly located on the anterior abdominal wall (5 cases) and there was a lumbar hernia. All patients presented with associated injuries, intraabdominal (5 cases), and bone fractures (2 cases). Two patients had a seat-belt sign. Four patients underwent urgent surgery in the first 24 hours; in 2 of them a primary closure of the defect was performed, and the other 2 were reconstructed using meshes. No mortality was recorded and only one early hernia recurrence was observed.
Conclusion: TAWH is a rare injury that occurs in less than 1% of blunt trauma cases. Its diagnosis and treatment are challenging. It is important to individualize its management and to evaluate the risk-benefit of urgent vs delayed reconstructions of the abdominal wall, depending on the associated injuries and the clinical status of the patient.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
no