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Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report.

Biswas S, Vedanayagam M, Hipkins G, Leather A - World J Emerg Surg (2010)

Bottom Line: At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis.A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers.To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal.Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Kings College Hospital, Denmark Hill, SE5 9RS, London. seemabiswas@hotmail.com.

ABSTRACT
We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers.To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

No MeSH data available.


Related in: MedlinePlus

Skin closure.
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Figure 7: Skin closure.

Mentions: The edge of the peritoneum was sutured to the lacunar and pectineal ligaments and pectineal line. The overlying external oblique aponeurosis was re-attached as the inguinal ligament (Fig. 5). A large piece of prolene mesh extending from the anterior superior iliac spine to the pubic tubercle was then sutured beneath the external oblique aponeurosis (Fig. 6). The external oblique was closed and skin closure achieved in layers (Fig. 7). Post-operatively the patient received antibiotics for 5 days, made an uneventful recovery and was discharged within 12 days of the initial injury. At outpatient follow-up 6 months later there were no complications.


Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report.

Biswas S, Vedanayagam M, Hipkins G, Leather A - World J Emerg Surg (2010)

Skin closure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2902452&req=5

Figure 7: Skin closure.
Mentions: The edge of the peritoneum was sutured to the lacunar and pectineal ligaments and pectineal line. The overlying external oblique aponeurosis was re-attached as the inguinal ligament (Fig. 5). A large piece of prolene mesh extending from the anterior superior iliac spine to the pubic tubercle was then sutured beneath the external oblique aponeurosis (Fig. 6). The external oblique was closed and skin closure achieved in layers (Fig. 7). Post-operatively the patient received antibiotics for 5 days, made an uneventful recovery and was discharged within 12 days of the initial injury. At outpatient follow-up 6 months later there were no complications.

Bottom Line: At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis.A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers.To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal.Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Kings College Hospital, Denmark Hill, SE5 9RS, London. seemabiswas@hotmail.com.

ABSTRACT
We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers.To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

No MeSH data available.


Related in: MedlinePlus