A case of traumatic abdominal wall hernia with delayed bowel obstruction

BACKGROUND: Traumatic abdominal hernia is rare and difficult to diagnose from physical symptoms. PATIENT: A 60-year-old woman was admitted to the emergency department with complaints of vomiting after falling off a bicycle and hitting her abdomen against one of the handlebars 2 days earlier. Computed tomography (CT) demonstrated abdominal wall hernia from blunt trauma to the left upper abdomen. The patient underwent exploratory laparotomy, and the herniated bowel loop was not found to be perforated or gangrenous. Primary hernia repair without resection of the bowel loop was performed. RESULTS: Postoperative course was uneventful. CONCLUSION: Surgical exploration with primary repair of the defect is the definitive treatment in the present case, as the hernia contained an incarcerated loop of small bowel. The use of abdominal CT to confirm the diagnosis before operative repair of the hernia appears to be a safe and efficacious adjunct to physical examination.