title: Traumatic abdominal wall hernia in two adults: a case series.
abstract: BACKGROUND
  Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management.
  
  
  METHODS
  A 40-year-old woman from rural north India presented with a low-velocity blunt injury to the lower abdomen. She was attacked by a bull. She had a clinically evident abdominal fascial disruption with intact skin, and was hemodynamically stable. An emergency mesh repair of the defect was performed, and she recovered well. A 38-year-old man from rural north India presented with blunt trauma to the abdomen following a motor vehicle accident. He was stable, with a central abdominal parietal wall swelling and bruising. A computed tomography scan revealed herniation of bowel loops in the area with minor intra-abdominal injuries. A laparotomy, resection-anastomosis of the ischemic bowel, and primary repair of the defect was performed and he recovered well.
  
  
  CONCLUSIONS
  Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.
authors.affiliation: Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital Vivek Vihar, Delhi 110095 India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Agarwal
authors.forename: Sunil
authors.initials: S
authors.lastname: Kumar
authors.forename: Mohit Kumar
authors.initials: MK
authors.lastname: Joshi
authors.forename: Mriganka Sekhar
authors.initials: MS
authors.lastname: Sharma