TAWHTraumatic Abdominal Wall Hernia
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References in periodicals archive ?
Although TAWH and evisceration are significant clinical conditions, the main factor determining mortality is the presence of additional organ injuries.
Traumatic abdominal wall hernia (TAWH): A case study highlighting surgical management.
The clinical presentation of TAWH typically involves a tender soft tissue mass on the abdomen (31%) or an associated ecchymosis (49%).
Early reports of patients with TAWH recommended early operative exploration and repair due to the high risk of concomitant intraabdominal injuries and potential for incarceration [9, 10].
In summary, the management of TAWH and TIH is complicated given the high association with other concomitant intraabdominal and musculoskeletal injuries particularly with pelvic fractures.
CONCLUSION: TAWH should be suspected in a patient with tender, localised swellings of the abdominal wall following blunt trauma (1).
TAWH remains a rare clinical entity and insufficient evidence exists to provide clear protocols for surgical management.
A conservative or delayed operative management strategy for low energy TAWH may be feasible, but high-energy TAWH are often associated with significant intra-abdominal injuries and an operative approach via midline laparotomy has been advocated [5].
Due to the potential for contamination in cases of high-energy TAWH repair, a primary suture repair technique has been recommended by some authors because of the high (50%) wound infection rate even when mesh was not used [5].
In children, the most common low-energy TAWH is the type 1, which results from a bicycle accident where the abdomen impacts upon the end of the handlebars.
This is in contrast to other types of TAWHs, such as those resulting from high-energy trauma where associated injuries are common.