title: Traumatic abdominal wall herniation.
abstract: Most reported cases of traumatic abdominal wall herniation result from seatbelt or handlebar injuries. The diagnosis is often made on physical examination or abdominal computed tomography (CT). We report a 59-year-old man with traumatic herniation through the rectus muscle following low-velocity blunt abdominal trauma. This patient was initially thought to have a rectus sheath haematoma and initial CT showed a soft tissue haematoma over the left lower anterior abdominal wall but no herniation. The traumatic herniation was diagnosed four days later, and confirmed on CT. Intraoperatively, a segment of the sigmoid colon was found to have herniated through the rectus defect and was gangrenous with impending perforation. A left hemicolectomy followed by primary repair of the defect was done. This case highlights the need for a high index of suspicion for traumatic herniation in patients who sustain low-velocity blunt abdominal wall trauma even when initial CT scans are negative.
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, 11 Tan Tock Seng Road, Singapore 308433.
authors.forename: E Y
authors.initials: EY
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Kaushal
authors.forename: W Y
authors.initials: WY
authors.lastname: Siow
authors.forename: K H
authors.initials: KH
authors.lastname: Chia
mesh_terms: D003106:Colon / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D046449:Hernia, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D017568:Rectus Abdominis / Q000293:injuries* / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications*