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Bullhorn hernia: a rare traumatic abdominal wall hernia.

Singh B, Kumar A, Kaur A, Singla RL - Niger J Surg (2015 Jan-Jun)

Bottom Line: Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation.We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region.A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Government Medical College and Rajindra Hospital, Patiala, Punjab, India.

ABSTRACT
Traumatic abdominal wall hernia (TAWH) is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.

No MeSH data available.


Related in: MedlinePlus

Swelling left lumbar region with echymosis
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Figure 1: Swelling left lumbar region with echymosis

Mentions: A 70-year-old male was presented to the emergency department after being hit by a bull. He presented with a complaint of pain in the abdomen and swelling in the left lumbar region [Figure 1]. On presentation, his vital parameters (blood pressure: 120/80, pulse rate: 72/min, respiratory rate: 18/min, temperature: afebrile) were stable. On physical examination, his left abdomen was found to have a bulging mass, not reducible, without definite ecchymosis. There was mild tenderness and rebound tenderness over the protrusion, but there was no muscle guarding or generalized tenderness over the whole abdomen. We suspected the abdominal protrusion to be caused by a fascial disruption, although the demarcation could not be clearly delineated by physical examination. The bowel sounds were normal. The findings from the initial laboratory studies were normal. Chest and abdomen X-rays were normal. Abdominal ultrasound showed a small amount of free fluid in perihepatic space, pelvis, and in between gut loops and protrusion of omentum from lateral abdominal wall.


Bullhorn hernia: a rare traumatic abdominal wall hernia.

Singh B, Kumar A, Kaur A, Singla RL - Niger J Surg (2015 Jan-Jun)

Swelling left lumbar region with echymosis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4382648&req=5

Figure 1: Swelling left lumbar region with echymosis
Mentions: A 70-year-old male was presented to the emergency department after being hit by a bull. He presented with a complaint of pain in the abdomen and swelling in the left lumbar region [Figure 1]. On presentation, his vital parameters (blood pressure: 120/80, pulse rate: 72/min, respiratory rate: 18/min, temperature: afebrile) were stable. On physical examination, his left abdomen was found to have a bulging mass, not reducible, without definite ecchymosis. There was mild tenderness and rebound tenderness over the protrusion, but there was no muscle guarding or generalized tenderness over the whole abdomen. We suspected the abdominal protrusion to be caused by a fascial disruption, although the demarcation could not be clearly delineated by physical examination. The bowel sounds were normal. The findings from the initial laboratory studies were normal. Chest and abdomen X-rays were normal. Abdominal ultrasound showed a small amount of free fluid in perihepatic space, pelvis, and in between gut loops and protrusion of omentum from lateral abdominal wall.

Bottom Line: Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation.We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region.A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Government Medical College and Rajindra Hospital, Patiala, Punjab, India.

ABSTRACT
Traumatic abdominal wall hernia (TAWH) is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.

No MeSH data available.


Related in: MedlinePlus