Traumatic abdominal wall hernia

BACKGROUND
Traumatic abdominal wall hernia (TAWH) is uncommonly encountered despite the high prevalence of blunt abdominal trauma. The diagnosis is often difficult because of its varied presentation along with lack of awareness of this entity.
METHODS
The case files of all patients with TAWH who were operated at our hospital were retrospectively reviewed and analyzed.
RESULTS
A total of 11 patients with TAWH were analyzed (8 males, 3 females). The clinical presentation was varied, with a palpable defect and a reducible swelling (6 patients), localized area of irreducible swelling (3 patients), surgical emphysema (2 patients), and cellulitis/abscess formation (2 patients). All of these patients were operated within 24 hours of hospital admission. Except for the 3 patients who presented late, there was a favorable outcome in all the others. The cause of mortality was septicemia, possibly due to incarceration of bowel in the defect leading to strangulation and perforation.
CONCLUSION
TAWH, although uncommon, is associated with significant morbidity and mortality when there is a delay in diagnosis and intervention. Early intervention leads to a significantly better outcome.

Travmatik karýn duvarý hernisi

AMAÇ
Künt karýn travmasýnýn yüksek prevalansýna karþýn, travmatik karýn duvarý hernisi (TKDH) ile nadiren karþýlaþýlmaktadýr. Deðiþken prezantasyonu ile birlikte bu antiteye iliþkin farkýndalýðýn azlýðý nedeniyle tanýsý güçlükle konulmaktadýr.
GEREÇ VE YÖNTEM
Hastanemizde ameliyat edilen TKDH’li bütün hastalarýn dosyalarý, retrospektif olarak gözden geçirildi ve analiz edildi.
BULGULAR
TKDH’li toplam 11 hasta deðerlendirildi (8 erkek, 3 kadýn). Klinik tablo çeþitliydi; palpe edilebilen bir defekt ve redükte edilebilir þiþlik (n=6), redükte edilemeyen þiþliðe iliþkin lokalize alan (n=3), cerrahi amfizem (n=2) ve sellülit/apse formasyonu (n=2). Hastalarýn tamamý, hastaneye yatýrýlmalarýndan itibaren 24 saat içinde ameliyat edildi. Geç baþvuran 3 hasta dýþýnda kalanlarda, sonuç olumlu idi. Mortalite nedeni muhtemelen baðýrsaðýn boðulmasý ile geliþen perforasyona baðlý septisemi idi.
SONUÇ
Nadir olmakla birlikte TKDH, taný ve müdahalede bir gecikme olmasý durumunda anlamlý morbidite ve mortalite ile birliktedir. Erken giriþim sonucu anlamlý olarak iyileþtirmektedir.