2019 Volume 39 Issue 6 Pages 1069-1074
We present herein on a 20-year-old man, who was involved in a motorcycle accident. He was admitted to our hospital under the suspicion of internal bleeding within the abdominal cavity. Contrast enhanced computed tomography (CT) revealed a traumatic abdominal wall hernia along with the rupture of the right abdominal oblique muscles and the transverse abdominal muscle. The CT examination also showed right kidney injury and ascending colonic mesenteric injury, which were managed conservatively to prevent further complications. On the 5th day of his admission, a hernia repair was performed through the anterior side with fascial closure and mesh placement. Fourteen cases of traumatic abdominal wall hernia have been reported in the literature since laparoscopic surgery was first reported in Japan. Reflecting on the relationship between the time from injury to the onset of symptoms and the operative methods chosen in the cases of early repair, we sutured the abdominal wall fascia via the anterior approach, and laparoscopic surgeries were performed for the delayed onset cases. In the present case, the abdominal wall fascia was sutured with the anterior approach, and good results were obtained. Early treatments have been reported involving the anterior approach facilitating fascial closure for traumatic abdominal wall hernia, which might lead to improvement of quality of life. The timing and the operative methods should be chosen taking the onset of symptoms and the comorbidity into consideration.
