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Traumatic abdominal wall injuries in postmortem CT
Dietrich Stoevesandt1, Lina Woydt2, Lisa-Maria Peter2
1Department of Radiology, University Hospital Halle, Ernst-Grube-Straße 40, Halle/Saale, 06120, Germany. dietrich.stoevesandt@uk-halle.de.
International Journal of Legal Medicine
|May 28, 2026
Summary
Traumatic abdominal wall hernia (TAWH) is significantly more common in fatal traffic accidents than previously thought. This finding highlights TAWH as a key indicator of severe trauma, particularly in seatbelted occupants.
Area of Science:
- Forensic pathology
- Trauma research
- Radiology
Background:
- Traumatic abdominal wall hernia (TAWH) is a rare injury from blunt trauma, often from high-energy events like car crashes.
- Its incidence in fatal trauma is not well-documented.
- This study investigates TAWH frequency in postmortem CT scans of traffic fatalities.
Purpose of the Study:
- Determine the incidence of TAWH in traffic fatalities using postmortem CT.
- Analyze associated injuries and patterns, especially in motor vehicle occupants (MVO).
Main Methods:
- Retrospective review of 411 traffic fatalities (2011-2023).
- Systematic assessment for TAWH in 218 cases using postmortem CT.
- Data collection included demographics, seatbelt use, accident details, and injuries.
Main Results:
- TAWH found in 20.6% of cases, much higher than clinical reports.
- In motor vehicle occupants, TAWH incidence was 19.4%.
- TAWH correlated with sternal fractures, rib fractures, and sacroiliac joint injuries, particularly in seatbelted individuals.
Conclusions:
- TAWH is a significant marker of fatal high-energy trauma.
- Its prevalence in postmortem studies exceeds clinical findings.
- TAWH may indicate severe trauma in restrained occupants, warranting further biomechanical research.
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