Blunt trauma-induced abdominal wall hernia with small bowel incarceration: case report and review of the literature

BACKGROUND: Traumatic abdominal wall hernia (TAWH) is a rare sequela of blunt abdominal trauma, characterized by disruption of the abdominal musculature and fascia without skin penetration. Diagnosis may be challenging and delayed, with complications such as bowel incarceration or strangulation requiring urgent intervention. This report describes a TAWH complicated by bowel obstruction, followed by a narrative review of relevant literature. CASE PRESENTATION: A 69-year-old male presented with acute abdominal pain, vomiting, and a right flank mass, three days after a road traffic accident. Physical examination revealed a tender, irreducible swelling with overlying abrasions and ecchymosis. Laboratory results were unremarkable. Contrast-enhanced computed tomography (CT) demonstrated an anterior abdominal wall defect containing dilated small bowel loops with features of obstruction and possible strangulation. Emergency exploratory laparotomy revealed incarcerated but viable bowel loops within a traumatic defect. The loops were reduced, and a preperitoneal mesh repair was performed. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 3. CONCLUSION: TAWH, though rare, should be suspected in patients with localized swelling after blunt trauma. Prompt imaging and timely surgical repair are essential to prevent life-threatening complications.