Traumatic abdominal wall hernia in context of pelvic fracture: A case report

Abstract

Background: Traumatic abdominal wall hernias (TAWH) are rare but clinically significant injuries following traumatic injuries. TAWH arises as a result in shear forces to the abdominal wall and a sudden increase in intra-abdominal pressure following direct trauma. Its association with pelvic fractures is further more uncommon and infrequently described in literature. TAWHs may not present with obvious clinical signs and 20% of TAWHs are missed on initial diagnosis. Case presentation: We present the case of a 31-year-old male motorcyclist involved in a collision with a motor car, sustaining a pelvic fracture and left femur shaft fracture. This patient was noted to have a traumatic abdominal wall injury with a large fascial defect only during definitive fixation of his pelvic fracture. He required subsequent surgical repair of the defect at a separate operative setting. Conclusion: It is important for clinicians to be aware of TAWHs and their association with abdominal/pelvic injuries. CT scan is the diagnostic modality of choice. Timely diagnosis allows for better planning and coordination of care across relevant surgical subspecialties, minimizes the number of operations the patient has to go through and avoids delayed complications.