Body wall ruptures: when to cut

摘要

The likely contents of a hernia may be predicted based on its location. Sharp or penetrating trauma can result in herniation at any location in the abdominal wall. The location of body wall hernia, secondary to blunt abdominal trauma, largely dependson the direction of the traumatic force, intraabdominal pressure changes and abdominal wall anatomy (direction and insertion of aponeuroses), Blunt abdominal traumas most commonly result in hernias in the lateral areas of the abdominal wall (Figure 2). Paracostal hernias occur immediately caudal to the last rib where the external abdominal oblique and transversus abdominis muscles separate from their origin on the rib or costal cartilage. Dorsolateral hernias occur due to muscle avulsion from the transverse processes of the lumbar vertebrae. Prepubic and femoral hernias are other common locations for traumatic body wall hernia secondary to blunt trauma (Figure 3 overleaf).