牛の激突による外傷性白線ヘルニアの1例

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  • A CASE OF TRAUMATIC ABDOMINAL WALL HERNIA (LINEA ALBA HERNIA) FOLLOWING BOVINE COLLISION

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A 44-year-old man brought by ambulance to the hospital after being butted in the lower abdomen while working in a cowshed on January 13, 2003, had normal vital signs on admission. Lower abdominal distension was visible and peristalsis was detected subcutaneously. Abdominal CT showed deviation of the intestinal tract subcutaneously in the infraumbilical region at the anterior surface of the rectus abdominis muscle, and swelling with fluid retention on the dorsal side of the horizontal part of the duodenum. A traumatic abdominal wall hernia was diagnosed and duodenal damage suspected, neces-sitating surgery on the same day. Surgery showed a tear from the anterior rectus sheath to the peritoneum at the linea alba and prolapse of the small intestine into the subcutaneous space. A hematoma was detected near Treiz's ligament, but no damage to the intestinal tract or other organs was found. The damaged and weakened part of the abdominal wall was repaired using a Proline® hernia system (PHS). The patient recovered well and was discharged on day 15. Ten months after surgery, he continues to well.

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