Wood R J, Ney A L, Bubrick M P
Department of Surgery, Hennepin County Medical Center, Minneapolis, MN 55415.
Am Surg. 1988 Nov;54(11):648-51.
Traumatic abdominal hernia remains a rare clinical entity despite an overall increase in blunt abdominal trauma. What appears to be the most extensive traumatic abdominal hernia so far described is presented. Traumatic abdominal herniae fall into three general categories: small lower quadrant abdominal defects and inguinal hernias, typically the result of blunt trauma with bicycle handlebars, are the most common; larger abdominal wall defects sustained in motor vehicle accidents are the next most common hernias; intra-abdominal herniations through rents in the retroperitoneum are rarely seen. The diagnosis may often be established with physical examination alone. Conventional radiology, computerized tomography, and ultrasound have also proven useful. Because of the high incidence of other associated intra-abdominal injuries, early exploration and repair through a midline incision is advocated. Adequate debridement and solid repair of fascial planes with non-absorbable sutures are required to prevent recurrence.
尽管钝性腹部创伤总体上有所增加，但创伤性腹疝仍然是一种罕见的临床病症。本文介绍了迄今为止所描述的似乎最为广泛的创伤性腹疝。创伤性腹疝大致可分为三类：下腹部小象限缺损和腹股沟疝，通常是由自行车车把钝性创伤所致，最为常见；机动车事故中造成的较大腹壁缺损是次常见的疝；经腹膜后裂孔形成的腹内疝则很少见。诊断通常仅通过体格检查即可确立。传统放射学、计算机断层扫描和超声检查也已证明很有用。由于其他相关腹内损伤的发生率很高，主张早期经中线切口进行探查和修复。需要用不可吸收缝线对筋膜平面进行充分清创和牢固修复，以防止复发。
