Title : Traumatic lower anterior abdominal wall hernia: A precise diagnosis not easy to reach
Abstract:
Background: Pediatric traumas are routinely categorized into blunt and penetrating types. Bicycle handlebar exerts a biphasic or dual effect (it is primarily a blunt mechanism but due to its focused effect, it disrupts the muscles without cutting the skin). In 1964, Roberts reported a 9-year-old boy with acquired abdominal wall hernia after a fall upon a bicycle handlebar to be the second case of traumatic abdominal wall hernia (TAWH) after Landry report in 1956.
Since then, more than 66 pediatric cases have been reported. In dealing with cases having this type of injury, radiologic studies are warranted to reveal the injured anatomic walls and organs, address these injuries, and achieve optimum case stabilization. Here in this article, we present our experience in management of pediatric traumatic abdominal wall hernia case and literature review.
Case Presentation: An 11-years-old boy presented to the ER of Al-Hussein university hospital with traumatic ventral hypogastric hernia caused by bicycle handlebar impact to his lower abdomen. The case was initially assessed, stabilized, managed operatively and followed until improved and became ready for discharge.
Conclusion: Traumatic abdominal wall hernias occur in response to concentrated impact by handlebar to the abdomen leading to muscle yielding but the resilient elastic nature of the skin keeps it intact. These injuries should be suspected in the setting of suggestive trauma mechanism followed by abdominal swelling and should be dealt with timely and seriously on an individual basis to restore the disrupted anatomy.
