Suhail Dernas, Smith Olivia, Lim Philip, Chintapatla Srinivas
Hull York Medical School University of York, University Rd, York, UK.
York Abdominal Wall Unit York Teaching Hospital, Wigginton Road, York, UK.
Case Rep Surg. 2024 Jul 9;2024:8868853. doi: 10.1155/2024/8868853. eCollection 2024.
Rupture of the rectus abdominis is a rare condition. We describe the case of a young male trainee paratrooper who presented with sudden onset severe lower abdominal pain that occurred during military training. Magnetic resonance imaging revealed full-thickness bilateral rupture of the rectus abdominis. Our management involved injecting botulinum toxin into the rectus muscles preoperatively, reconstructing the rectus muscles, and placing a supportive biosynthetic mesh. Postoperatively, our patient could walk pain-free at 3 weeks, jog pain-free at 10 weeks, and run up to 2 miles at 25 weeks. As there is no consensus on the management of this rare injury, we conducted a literature review on all cases reporting rupture of the rectus abdominis from the year 2000. After comparing the outcomes of conservatively versus surgically managed patients, we can conclude that generally, management of such defects is dependent on size, severity, and patient factors; however, surgical treatment yields comparable results to conservative treatment.
腹直肌破裂是一种罕见的病症。我们描述了一名年轻男性实习伞兵的病例，他在军事训练期间突然出现严重的下腹部疼痛。磁共振成像显示腹直肌全层双侧破裂。我们的治疗方法包括术前向腹直肌注射肉毒杆菌毒素、重建腹直肌以及放置支撑性生物合成网片。术后，我们的患者在3周时能够无痛行走，10周时能够无痛慢跑，25周时能够跑2英里。由于对于这种罕见损伤的治疗尚无共识，我们对2000年以来所有报告腹直肌破裂的病例进行了文献综述。在比较保守治疗和手术治疗患者的结果后，我们可以得出结论，一般来说，此类缺损的治疗取决于缺损大小、严重程度和患者因素；然而，手术治疗与保守治疗的效果相当。
