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由自行车手把直接创伤导致的创伤性腹壁膨出疝(TAWH)较少见。目前只有21例手把创伤性疝的报道。一个11岁男童从其自行车上摔下来并且车把撞击到其右下腹部位。后来被送到急诊室。患者的生命体征和最初的实验室检查都正常。体格检查表明在右下皮肤表面有瘀斑,软组织肿胀并且触诊有压痛。CT表明肠管环形突出,通过腹壁缺损进入腹壁皮下间隙。外科手术探查发现缺损贯穿整个腹壁包括筋膜、肌层和腹膜,肠管通过缺损突出到皮下间隙。对所有缺损逐层修补且术后男童的病情平稳。作者建议在临床中对所有创伤性腹壁损伤要高度怀疑TAWH的存在。关键的治疗是外科手术检查时对所有腹壁组织层进行初次修补。
Traumatic abdominal wall hernia (TAWH) caused by direct trauma to bicycle handrails is less common. Currently only 21 cases of traumatic hernia reported. An 11-year-old boy fell off his bike and hit the handlebars to his right lower abdomen. Was later sent to the emergency room. The patient’s vital signs and initial laboratory tests are normal. Physical examination showed ecchymosis on the lower right skin surface, swollen soft tissue and palpation tenderness. CT showed that the intestine ring protruding through the abdominal wall defects into the abdominal subcutaneous space. Surgical exploration found that the defect throughout the abdominal wall including the fascia, myometrium and peritoneum, bowel through the defect protruding to the subcutaneous space. Repair all defects layer by layer and the condition of postoperative boys is stable. The authors suggest that the presence of TAWH be highly suspected in all traumatic abdominal wall injuries in the clinic. The key treatment is the initial repair of all the layers of the abdominal wall at the time of surgical examination.