Traumatic abdominal wall hernias: A 15-year single-center experience in diagnosis and management

Traumatic abdominal wall hernia (TAWH) is a rare injury caused by high-energy blunt trauma. Its diagnosis is often missed, and the current management strategies remain inconsistent. This study aimed to describe the clinical characteristics, diagnostic challenges, and surgical outcomes of TAWH based on a 15-year experience at a high-volume trauma center in Korea.

We retrospectively reviewed the records of patients diagnosed with TAWH between 2010 and 2024. The data included demographics, injury mechanisms, hernia features, surgical timing, and outcomes.

Of 17,852 patients with blunt abdominal trauma, 28 (0.16%) were diagnosed with TAWH. Although CT identified most hernias (96.4%), only 48.1% were noted in official radiology reports. Common hernia locations were lumbar (38.7%) and anterior (29.0%). Associated intra-abdominal injuries were present in 89.3% of cases. Surgical repair was performed in 22 patients, with 90.9% undergoing early repair during the index admission. Two patients underwent delayed mesh repair, without recurrence. Overall recurrence and surgical site infection rates were both 18.2%.

TAWH remains under-recognized despite its strong association with high-energy trauma and clear CT detectability. Findings from this long-term single-center study support early repair when feasible and selective delayed mesh repair is performed in appropriate patients, underscoring the need for greater awareness among trauma providers.