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Traumatic Abdominal Wall Hernia in Children: A Systematic Review
Christina M Theodorou1, Sarah C Stokes1, Alana L Beres1
1Department of Pediatric General, Thoracic, and Fetal Surgery, University of California Davis Medical Center, Sacramento, California.
The Journal of Surgical Research
|February 18, 2021
Summary
Traumatic abdominal wall hernias in children are rare but often involve serious intra-abdominal injuries. Management is typically surgical, with low recurrence rates observed in this systematic review.
Area of Science:
- Pediatric surgery
- Trauma surgery
- Systematic reviews
Background:
- Traumatic abdominal wall hernia (TAWH) in children is an uncommon injury resulting from blunt abdominal trauma.
- There is no established consensus for managing these rare pediatric cases.
- This systematic review aims to consolidate current knowledge on TAWH in children.
Purpose of the Study:
- To systematically review and describe the characteristics of traumatic abdominal wall hernias in pediatric patients.
- To analyze the associated injuries, management strategies, and outcomes for pediatric TAWH.
- To provide insights into the current understanding and treatment of this rare condition.
Main Methods:
- A systematic literature search was conducted following PRISMA guidelines across major databases (PubMed, Web of Science, Embase, Google Scholar).
- English-language publications detailing blunt TAWH in patients under 18 years old were included.
- Data extraction focused on demographics, injury mechanisms, associated intra-abdominal injuries, surgical management, and patient outcomes.
Main Results:
- A review of 71 articles identified 100 cases of pediatric TAWH, predominantly in males (82.5%) with a median age of 9 years.
- Bicycle handlebar injuries were the most frequent cause (72%), followed by motor vehicle collisions (14%).
- Intra-abdominal injuries occurred in 40% of patients, significantly more common with non-bicycle handlebar trauma (60.7% vs. 33.3%). Laparotomy was the primary surgical approach (80%), with low reported complications and no recurrences at a median follow-up of 5 months.
Conclusions:
- Pediatric traumatic abdominal wall hernia is a rare injury associated with a high incidence of intra-abdominal damage, especially from high-impact events.
- While open repair is common, successful laparoscopic approaches have been documented.
- Observed recurrence rates are low, though long-term follow-up data remain limited.
