Traumatic abdominal wall hernias: Location matters

Jamie J. Coleman, Evan K. Fitz, Ben L. Zarzaur, Scott Steenburg, Brian L. Brewer, R. Lawrence Reed, David V. Feliciano

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

BACKGROUND: Because of its uncommon nature and a lack of comprehensive literature, abdominal wall hernias caused by blunt trauma continue to present a management dilemma. This study was performed to identify the incidence of associated injuries, the need for urgent operative intervention, and recurrence rates after hernia repair. METHODS: A retrospective review of patients diagnosed with a traumatic abdominal wall hernia from January 2002 to December 2014 was performed.Datawere collected fromthe trauma registry and included patient demographics, location and type of hernia, associated injuries, operative interventions, complications, and length of stay. RESULTS: Eighty patients (64% male; median age, 36 years; mean Injury Severity Score [ISS], 22) were identified during the study period. A motor vehicle collision was the most frequent mechanism of injury (n = 58). Overall, 35 patients (44%) underwent urgent laparotomy or laparoscopy, and 10 of these (29%)were nontherapeutic excluding hernia repair. Of interest, 17 patients (49%) required bowel resection. Notably, the need for operative intervention and nontherapeutic rate differed depending on hernia location. Hernia repair was performed in 23 patients, the majority of whom (78.3%) underwent repair within 5 days of injury. There were six recurrences, four ofwhich were repaired acutely (within 1 week of injury), with an overall first-time hernia recurrence rate of 26%. CONCLUSION: In the largest series to date, traumatic abdominal wall hernias were found to be associated with a high percentage of intraabdominal injuries requiring urgent laparotomy or laparoscopy. Rates of therapeutic interventions varied by hernia location, with anterior abdominal hernias associated with the highest need for a therapeutic operation. Acute repair was associated with the majority of the recurrences.

Original languageEnglish (US)
Pages (from-to)390-397
Number of pages8
JournalJournal of Trauma and Acute Care Surgery
Volume80
Issue number3
DOIs
StatePublished - 2016

Keywords

  • Abdominal wall hernia
  • Blunt trauma
  • Hernia
  • Traumatic abdominal wall hernia
  • Traumatic hernia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

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    Coleman, J. J., Fitz, E. K., Zarzaur, B. L., Steenburg, S., Brewer, B. L., Reed, R. L., & Feliciano, D. V. (2016). Traumatic abdominal wall hernias: Location matters. Journal of Trauma and Acute Care Surgery, 80(3), 390-397. https://doi.org/10.1097/TA.0000000000000946