A Case of a Large Traumatic Abdominal Wall Hernia

Abstract

A 70-year-old woman sustained abdominal injury by a harvester’s bucket while farming. She visited our hospital for surgical treatment of a traumatic abdominal wall hernia (TAWH). Physical examination revealed a bulge in the upper abdomen with a 20 × 10 cm bruise. On day 3, we performed open ventral hernia repair without a mesh, and on day 12, she was discharged. She showed no evidence of recurrence at the 3-month follow-up. Until now, a total of 14 cases of large TAWH have been reported in Japan. Of these, 6 patients were treated by early laparotomy, and 8 patients were treated by laparoscopic repair. Mesh repair has been undertaken in 9 cases. Delayed surgery results in progressive tissue regression, and the abdominal wall defect increases in proportion to the size of the TAWH, making suture repair difficult. In stable patients without intra-abdominal organ damage, surgery should be considered as early as possible.