• Ian Gutteridge, Keith Towsey, and Cliff Pollard.
• Department of General Surgery, Royal Brisbane Hospital, Brisbane, Queensland, Australia.
• ANZ J Surg. 2014 Mar 1; 84 (3): 160-5.

BackgroundTraumatic abdominal wall hernia (TAWH) is a rare type of hernia occurring secondary to blunt trauma to the abdomen. Its management remains controversial within the surgical community, mainly due to complexities in diagnosis, appropriate surgical approach and timing of closure.MethodCases were identified retrospectively, via interviews with trauma surgeons at a Tertiary Trauma Centre, the Royal Brisbane & Women's Hospital, in Brisbane, Australia. In addition, data were collected via in-house trauma and operative databases.ResultsFive cases of TAWH were identified over a 3-year period. All cases involved injuries sustained from motor vehicle or motor bike accidents. Diagnosis was purely clinical in one case and clinically suspected, then confirmed by computed tomography in the remainder. Herniation was managed by immediate closure in one instance, delayed/staged closure in three cases and conservative management in the remainder. In addition, three of the five patients were obese. At minimal 3-month follow-up, no evidence of recurrence of herniation was present in four of the five cases. One case was lost to follow-up.ConclusionsTAWH is a complex injury to manage and no one approach is all encompassing. Correct diagnosis is essential as this allows proper planning for the method and timing of repair. This series highlighted that incorrect seatbelt placement, especially in the obese population, may be a risk factor for increased incidence of TAWH.© 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

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