Abstract
A 67-year-old man, who had a collision with a car while he had been riding his bicycle and had got a bruise on the lower abdomen, was appeared at the hospital by ambulance in October 2009. His vital signs were stable, an abdominal CT scan revealed no organ injuries, and then we prescribed rest at home with a diagnosis of abdominal contusion. Two days later, however, he was seen at the hospital again because of abdominal pain and vomiting. There was a bulge with remarkable tenderness at the midline of the subumbilical region. Another abdominal CT scan showed a prolapsed small intestine into the subcutaneous structure and dilatation of the proximal intestine. After the diagnosis of incarcerated traumatic abdominal wall hernia was made and emergency operation was performed. At surgery, disruption of the fascia and the peritoneum at the linea alba and the necrotic incarcerated small intestine were found. No injuries of other intra-abdominal organs were seen so that the resection of the small intestine and direct suture closure for hernia repair were performed. Despite surgical wound infection, the patient's postoperative course was uneventful and he was discharged from the hospital on the 39th hospital day.
