Traumatic abdominal wall hernias: a 20-year retrospective cohort study.

Area of Science:

• Trauma Surgery
• Diagnostic Imaging
• Abdominal Wall Injuries

Background:

• Traumatic abdominal wall hernias (TAWHs) are uncommon but serious injuries from blunt abdominal trauma.
• Despite low incidence, TAWHs are associated with significant morbidity and mortality.
• Effective management strategies are crucial for these patients.

Purpose of the Study:

• To assess the incidence and injury patterns of TAWHs.
• To evaluate optimal management strategies for TAWHs.
• To determine the role of CT in diagnosing TAWHs and associated injuries.

Main Methods:

• Retrospective cohort study at a level-1 trauma center over 20 years (October 2002 - October 2023).
• Identification of patients with TAWHs via trauma and radiological databases.
• Analysis of clinical data, CT findings, and management outcomes.

Main Results:

• 71 confirmed TAWHs out of 220 identified patients (mean age 45.2 years).
• High-speed motor vehicle collisions were the most common mechanism.
• CT findings like free gas, perforation, bowel ischemia, and herniation indicated need for immediate surgery; conservative management was successful for others.

Conclusions:

• Clinical vigilance and CT are vital for diagnosing TAWHs in high-energy trauma.
• Trauma laparotomy is essential for suspected intra-abdominal injuries.
• Select hemodynamically stable patients with TAWHs can be safely managed non-operatively.