Resumo
A rare case of blunt traumatic abdominal hernia is presented in which jejunal loops herniated through the abdominal wall. The patient had a serious motor vehicle accident seven years ago, while wearing the seat belt. He developed a traumatic hernia in the anterior lateral abdominal wall, which was operated, and relapsed after some months. The patient was reoperated and we observed the unattachment of the anterior lateral abdominal musculature from the ilium crest. After the hernial sac treatment, the defect was solved with the use of a polypropylene mesh. The postoperative evolution was good and four months later there were no signs of recurrence. Traumatic abdominal hernia remains a rare clinical entity, despite the increase in blunt abdominal trauma. Traumatic abdominal wall hernia falls into two general categories: small lower quadrant abdominal defects, typically the result of blunt trauma with bicycle handlebars, and larger abdominal wall defects related to motor vehicle accidents. The diagnosis may be often established by the physical examination alone. Conventional radiology and computerized tomography usefulness have been proved. In the vast majority of cases, early repair is recommended. The appropriate treatment is the reduction of the herniated bowel into the abdomen, the debridment of nonviable tissues, and a primary tension free closure of the detect.
Abdominal hernias; Trauma
Abdominal hernias; Trauma
RELATOS DE CASOS
Hérnia traumática da parede abdominal
Traumatic abdominal hernia
Alexandre Cruz Henriques, TCBC-SPI; Simone Chiconelli Henriques, ACBC-SPII; Carlos Alberto GodinhoIII
IProfessor Assistente do Departamento de Cirurgia da Faculdade de Medicina do ABC. Cirurgião do Serviço de Cirurgia Geral da lntermédica Sistema de Saúde - Hospital Príncipe Humberto
IICirurgião do Serviço de Cirurgia Geral da lntermédica Sistema de Saúde - Hospital Príncipe Humberto
IIIMédico Colaborador do Departamento de Cirurgia da Faculdade de Medicina do ABC
Endereço para correspondência Endereço para correspondência: Dr. Alexandre Cruz Henriques Rua Mediterrâneo, 928 - Jardim do Mar 09750-420 - São Bernardo do Campo - SP
ABSTRACT
A rare case of blunt traumatic abdominal hernia is presented in which jejunal loops herniated through the abdominal wall. The patient had a serious motor vehicle accident seven years ago, while wearing the seat belt. He developed a traumatic hernia in the anterior lateral abdominal wall, which was operated, and relapsed after some months. The patient was reoperated and we observed the unattachment of the anterior lateral abdominal musculature from the ilium crest. After the hernial sac treatment, the defect was solved with the use of a polypropylene mesh. The postoperative evolution was good and four months later there were no signs of recurrence. Traumatic abdominal hernia remains a rare clinical entity, despite the increase in blunt abdominal trauma. Traumatic abdominal wall hernia falls into two general categories: small lower quadrant abdominal defects, typically the result of blunt trauma with bicycle handlebars, and larger abdominal wall defects related to motor vehicle accidents. The diagnosis may be often established by the physical examination alone. Conventional radiology and computerized tomography usefulness have been proved. In the vast majority of cases, early repair is recommended. The appropriate treatment is the reduction of the herniated bowel into the abdomen, the debridment of nonviable tissues, and a primary tension free closure of the detect.
Key words: Abdominal hernias; Trauma.
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Full text available only in PDF format.
Recebido em 16/12/98
Aceito para publicação em 13/9/99
Trabalho realizado no Serviço de Cirurgia Geral da lntermédica Sistema de Saúde - Hospital Príncipe Humberto.
- 1. Ciftci AO, Salman B, Türken A, et al. Acute blunt traumatic abdominal hernia. J Pediatr Surg 1997;32:1.732-1.734.
- 2. Wood RJ, Ney AL, Bubrick MP. Traumatic abdominal hernia: a case report and review of the literature. Am Surg 1988;54:648-650.
- 3. Nadal SR, Guedes MAC, Silva CRA, et al. Hérnia traumática da parede abdominal. Rev Col Bras Cir 1995;5:296-8.
- 4. Perez VM, Mcdonald AO, Ghani A, et al. Handlebar hernia: a rare traumatic abdominal wall hernia. J Trauma 1998;44:568-569.
- 5. Ganchi PA, Orgill OP. Autopenetrating hernia: a novel form of traumatic abdominal wall hernia - case report and review of the literature. J Trauma 1996;41:1.064-1.066.
Datas de Publicação
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Publicação nesta coleção
24 Nov 2009 -
Data do Fascículo
Out 1999
Histórico
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Aceito
13 Set 1999 -
Recebido
16 Dez 1998