title: A case of traumatic abdominal wall hernia with delayed bowel obstruction.
abstract: BACKGROUND
  Traumatic abdominal hernia is rare and difficult to diagnose from physical symptoms.
  
  
  METHODS
  A 60-year-old woman was admitted to the emergency department with complaints of vomiting after falling off a bicycle and hitting her abdomen against one of the handlebars 2 days earlier. Computed tomography (CT) demonstrated abdominal wall hernia from blunt trauma to the left upper abdomen. The patient underwent exploratory laparotomy, and the herniated bowel loop was not found to be perforated or gangrenous. Primary hernia repair without resection of the bowel loop was performed.
  
  
  RESULTS
  Postoperative course was uneventful.
  
  
  CONCLUSIONS
  Surgical exploration with primary repair of the defect is the definitive treatment in the present case, as the hernia contained an incarcerated loop of small bowel. The use of abdominal CT to confirm the diagnosis before operative repair of the hernia appears to be a safe and efficacious adjunct to physical examination.
authors.affiliation: Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. kogushi1@msn.com.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishimura
authors.affiliation: Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. qq-nakao@hyo-med.ac.jp.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Nakao
authors.affiliation: Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. a-o-k@mail.goo.ne.jp.
authors.forename: Ayana
authors.initials: A
authors.lastname: Okamoto
authors.affiliation: Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. ntfujisaki@gmail.com.
authors.forename: Noritomo
authors.initials: N
authors.lastname: Fujisaki
authors.affiliation: Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan. kotanijo0412@gmail.com.
authors.forename: Joji
authors.initials: J
authors.lastname: Kotani
keywords: Abdominal hernia; Ileus; Trauma