Abstract
Posttraumatic abdominal wall hernias are extremely rare and are the result of the wall impact with an object that does not break the skin but has enough energy to disrupt the underlying muscular and fascia layers. One of the most frequent mechanisms for the pediatric population is the handle bar traumatic injury. We present the case of a 13-year-old male patient that was diagnosed with posttraumatic handlebar hernia in the right lower quadrant after performing a CT scan examination. The chosen surgical procedure was to repair the abdominal defect using an adaptation of the PIRS (percutaneous internal ring suturing) suturing technique assisted laparoscopically. The follow up of the case was uneventful.
Highlights
Traumatic abdominal wall hernias (TAWH) are exceedingly rare in the pediatric population
We report the case of a 13-year-old boy who presented with a handlebar hernia (HH) and was repaired using laparoscopically assisted percutaneous internal suturing procedure
TAWH are a rare pathology in the pediatric population and the available literature is based on case reports and statistics from few trauma centers that have small case series of this traumatic injury (2)
Summary
Traumatic abdominal wall hernias (TAWH) are exceedingly rare in the pediatric population. We present the case of a 13-year-old boy who was admitted to our surgical department 24 hours after a bicycle crash that had as a result the hitting of the right lower quadrant of the abdomen with the rubbercoated handlebar. He complained about abdominal pain and presence of a lump at the site of the traumatic injury. Computer tomography imaging confirmed the diagnosis of TAWH showing the disruption of internal and external oblique muscles, transverse abdominal muscles, peritoneum and herniation of the bowels (colon) through the defect into the subcutaneous space, with no other intraabdominal injury (Figures 2 and 3). Follow up after 4 weeks and 6 months revealed no recurrence (Figure 7)
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