Abstract
A acute traumatic abdominal hernia is rare and a Spigelian hernia is uncommon in the anterior abdominal wall. We report a case of Spigelian hernia caused by a traffic accident. A 20-year-old man, in a motor vehicle crash, was hemodynamically stable on arrival at the emergency department. Physical examination showed a fractured left femur, an irreducible 5.0×3.0 cm bulge in the left lower abdominal quadrant, and an avulsion of the musculature in the right lower abdominal quadrant with oppressive pain. Abdominal computed tomogra- phy (CT) showed a central rupture of the liver, fracture of the lumbar bone, and ruptures of the left and right lower abdominal wall with a herniated small intestine. We diagnosed the abdominal wall bulge as a traumatic Spigelian hernia and reduced the incarcerated hernia. Because of the hemodynamically stable condition, observation was elected to treat the central liver rupture. The man required 3 months of the bed rest for the fractures of the lumbar bone and left femur. During this time, the abdominal hernia shrank, finally healing after 3 month. Physical examination showed no bulge and no avulsion in the upright and standing positon, and no herniation was confirmed by abdominal CT or ultrasonography. He did well in follow-up without recurrence of hernia at 9 month after the trauma.
