Massive traumatic abdominal wall hernia with significant tissue loss: challenges in management
Autor: | Jordan Nantais, David Gomez, Graham Skelhorne-Gross, Noah Ditkofsky |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
medicine.medical_specialty Significant tissue loss medicine.medical_treatment Case Report Abdominal Injuries Abdominal wall 03 medical and health sciences 0302 clinical medicine Hollow viscus medicine Trauma centre Humans Hernia Evisceration (ophthalmology) Abdominal Muscles business.industry Abdominal Wall Abdominal wall reconstruction 030208 emergency & critical care medicine General Medicine Surgical Mesh medicine.disease Hernia Ventral Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Female business Motor vehicle crash |
Zdroj: | BMJ Case Rep |
Popis: | A 41-year-old woman presented to our trauma centre following a high-speed motor vehicle collision with a seatbelt pattern of injury resulting in extensive rupture of her abdominal wall musculature and associated hollow viscus injuries. The abdominal wall had vertical separation between transected rectus, bilateral transverse abdominis and oblique muscles allowing evisceration of small and large bowel into the flanks without skin rupture. Intraoperatively, extensive liquefaction and tissue loss of the abdominal wall was found with significant retraction of the remaining musculature. Initial operative management focused on repair of concomitant intra-abdominal injuries with definitive repair performed in delayed, preplanned stages including bridging with absorbable mesh and placement of an overlying split-thickness skin graft. The patient was discharged from hospital and underwent extensive rehabilitation. One year later, the abdominal wall was definitively repaired with components separation and biological mesh underlay. This stepwise repair process provided her with a robust and enduring abdominal wall reconstruction. |
Databáze: | OpenAIRE |
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