Traumatic abdominal wall hernia as a component of the seatbelt syndrome: A case report of complete abdominal wall muscle transection

• Published in: International journal of surgery case reports Vol. 122; p. 110017
• Main Authors: Gómez-Torres, I., Gamón-Giner, R.L., Menor-Duran, P.D., Queralt-Escrig, M., Jara-Benedetti, G., Alcobilla-Ferrara, E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.09.2024
• Subjects: 3D reconstruction; Abdominal wall avulsion; Case report; Seat belt syndrome; Traumatic abdominal wall hernia; Case report; 3D reconstruction; Seat belt syndrome; Traumatic abdominal wall hernia; Abdominal wall avulsion
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.110017

Seat belt syndrome (SBS) is a rare condition described as injuries sustained due to thoracic, abdominal, and pelvic compression in the context of traffic accidents. These injuries can range from minor skin abrasions to large lesions of internal organs and spinal cord involvement. Traumatic abdominal wall hernias (TAWH) are one of the injuries that can be associated. A 21-year-old male suffered a severe injury, resulting in complete transection of all abdominal wall musculature due to SBS, with associated visceral injury. Emergency surgery included intestinal and sigmoid colon resection, along with cava vein repair. After a prolonged recovery, a second-stage surgery for abdominal wall reconstruction was planned. Prehabilitation involved botulinum toxin and pneumoperitoneum, with surgical planning utilizing CT scan and 3D reconstruction. The second-stage surgery included transversus abdominis release and placement of double mesh. Managing traumatic abdominal wall hernias in polytrauma patients necessitates emergent surgery for vital injuries, while reconstructive surgery timing is crucial, with patient preparation being essential. Surgical planning, including 3D reconstructions, enhances accuracy, and safety, with repair technique selection depending on anatomical features. Given our patient's athletic background and preoperative vascular CT findings, flapless reconstructive surgery was chosen to mitigate vascular risks. The therapeutic approach to traumatic abdominal wall injuries should be individualized to each patient, with a focus on addressing vital injuries first and considering abdominal wall reconstruction surgery at a subsequent stage. Utilizing CT scan with 3D reconstruction can be a valuable tool for preoperative planning in cases involving significant abdominal wall defects. •Seat belt syndrome: trauma from compression, leading to internal injuries and traumatic hernias•Polytraumatic patient initial treatment: prioritize life-threatening injuries; address abdominal wall later•CT scan with 3D images can aid planification for abdominal wall surgery with large muscle defects.•Patient prehabilitation ensures optimal preoperative condition and postoperative outcomes.•Consider patient traits, needs, and anatomy conditions when choosing surgical technique