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A 36-year-old female patient sustained blunt abdominal trauma after a mountain bike crash, when the end of a wooden stump hit her abdomen. She had a 4cm diameter bruise, and tenderness in the left upper quadrant. Previously she had had an umbilical hernia repair and lower uterine segment Caesarean section (LUSCS).A CT scan (see Figure 1) demonstrated a small left-sided defect between the lateral edge of the left rectus abdominis muscle and the linea semilunaris. Soft tissue contusion overlying the hernia and a probable haematoma of the Psoas were noted along with a small amount of free fluid.By the next day a lump consistent with a Spigelian hernia was apparent in the area of injury just lateral to the left rectus abdominis. An abdominal binder was prescribed and the patient was discharged with minimal pain after 2 days.At follow-up 3 months post-injury her hernia had reduced in size clinically and was asymptomatic. By 6 months post-injury there was no residual defect or lump.Spigelian hernias after abdominal wall trauma have been reported before in children.1Losanoff2 described 13 paediatric patients who had hernias similar to Spigelian hernias that were related to trauma, but whether the same applies to adults has not been established.The significance of our case is that it provides some evidence that blunt trauma to the abdomen may play and aetiological role in the development of at least some Spigelian hernias in adults as well. Figure 1. CT scan Fraser Welsh Surgical Registrar Taranaki Base Hospital, New Plymouth Fraser.Welsh@tdhb.org.nz William Gilkison Consultant General Surgeon Taranaki Base Hospital, New Plymouth Spencer Beasley Clinical Professor of Paediatric Surgery Christchurch Hospital, Christchurch

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Fraser Welsh, Surgical Registrar, Taranaki Base Hospital, New Plymouth, William Gilkison, Consultant General Surgeon, Taranaki Base Hospital, New Plymouth, Spencer Beasley, Clinical Professor of Paediatric Surgery, Christchurch Hospital, Christchurch

Acknowledgements

Correspondence

Fraser Welsh

Correspondence Email

Fraser.Welsh@tdhb.org.nz

Competing Interests

Lopez R, King S, Maoate K, Beasley S. Trauma may cause Spigelian Hernia in children. ANZ J Surgery. 2010;80:663.Losanoff JE, Richman BW, Jones JW. Spigelian hernia in a child: case report and review of the literature. Hernia 2002;6:191-3.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

A 36-year-old female patient sustained blunt abdominal trauma after a mountain bike crash, when the end of a wooden stump hit her abdomen. She had a 4cm diameter bruise, and tenderness in the left upper quadrant. Previously she had had an umbilical hernia repair and lower uterine segment Caesarean section (LUSCS).A CT scan (see Figure 1) demonstrated a small left-sided defect between the lateral edge of the left rectus abdominis muscle and the linea semilunaris. Soft tissue contusion overlying the hernia and a probable haematoma of the Psoas were noted along with a small amount of free fluid.By the next day a lump consistent with a Spigelian hernia was apparent in the area of injury just lateral to the left rectus abdominis. An abdominal binder was prescribed and the patient was discharged with minimal pain after 2 days.At follow-up 3 months post-injury her hernia had reduced in size clinically and was asymptomatic. By 6 months post-injury there was no residual defect or lump.Spigelian hernias after abdominal wall trauma have been reported before in children.1Losanoff2 described 13 paediatric patients who had hernias similar to Spigelian hernias that were related to trauma, but whether the same applies to adults has not been established.The significance of our case is that it provides some evidence that blunt trauma to the abdomen may play and aetiological role in the development of at least some Spigelian hernias in adults as well. Figure 1. CT scan Fraser Welsh Surgical Registrar Taranaki Base Hospital, New Plymouth Fraser.Welsh@tdhb.org.nz William Gilkison Consultant General Surgeon Taranaki Base Hospital, New Plymouth Spencer Beasley Clinical Professor of Paediatric Surgery Christchurch Hospital, Christchurch

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Fraser Welsh, Surgical Registrar, Taranaki Base Hospital, New Plymouth, William Gilkison, Consultant General Surgeon, Taranaki Base Hospital, New Plymouth, Spencer Beasley, Clinical Professor of Paediatric Surgery, Christchurch Hospital, Christchurch

Acknowledgements

Correspondence

Fraser Welsh

Correspondence Email

Fraser.Welsh@tdhb.org.nz

Competing Interests

Lopez R, King S, Maoate K, Beasley S. Trauma may cause Spigelian Hernia in children. ANZ J Surgery. 2010;80:663.Losanoff JE, Richman BW, Jones JW. Spigelian hernia in a child: case report and review of the literature. Hernia 2002;6:191-3.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

A 36-year-old female patient sustained blunt abdominal trauma after a mountain bike crash, when the end of a wooden stump hit her abdomen. She had a 4cm diameter bruise, and tenderness in the left upper quadrant. Previously she had had an umbilical hernia repair and lower uterine segment Caesarean section (LUSCS).A CT scan (see Figure 1) demonstrated a small left-sided defect between the lateral edge of the left rectus abdominis muscle and the linea semilunaris. Soft tissue contusion overlying the hernia and a probable haematoma of the Psoas were noted along with a small amount of free fluid.By the next day a lump consistent with a Spigelian hernia was apparent in the area of injury just lateral to the left rectus abdominis. An abdominal binder was prescribed and the patient was discharged with minimal pain after 2 days.At follow-up 3 months post-injury her hernia had reduced in size clinically and was asymptomatic. By 6 months post-injury there was no residual defect or lump.Spigelian hernias after abdominal wall trauma have been reported before in children.1Losanoff2 described 13 paediatric patients who had hernias similar to Spigelian hernias that were related to trauma, but whether the same applies to adults has not been established.The significance of our case is that it provides some evidence that blunt trauma to the abdomen may play and aetiological role in the development of at least some Spigelian hernias in adults as well. Figure 1. CT scan Fraser Welsh Surgical Registrar Taranaki Base Hospital, New Plymouth Fraser.Welsh@tdhb.org.nz William Gilkison Consultant General Surgeon Taranaki Base Hospital, New Plymouth Spencer Beasley Clinical Professor of Paediatric Surgery Christchurch Hospital, Christchurch

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Fraser Welsh, Surgical Registrar, Taranaki Base Hospital, New Plymouth, William Gilkison, Consultant General Surgeon, Taranaki Base Hospital, New Plymouth, Spencer Beasley, Clinical Professor of Paediatric Surgery, Christchurch Hospital, Christchurch

Acknowledgements

Correspondence

Fraser Welsh

Correspondence Email

Fraser.Welsh@tdhb.org.nz

Competing Interests

Lopez R, King S, Maoate K, Beasley S. Trauma may cause Spigelian Hernia in children. ANZ J Surgery. 2010;80:663.Losanoff JE, Richman BW, Jones JW. Spigelian hernia in a child: case report and review of the literature. Hernia 2002;6:191-3.

Contact diana@nzma.org.nz
for the PDF of this article

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