A 6-year-old boy was admitted to the emergency department 3 days after a bicycle accident. The handlebar of his bicycle traumatized his abdominal wall above the left iliac crest. Twelve hours before the admission he noticed a palpable mass and a minor bruising to this specific point (Fig. ).\nThe physical examination revealed the presence of a painless swelling measuring 8 × 3 cm2 and did not reveal any pathological sign from the abdomen. The swelling was reducible, disappeared in supine position and increased by coughing. The diagnosis of a HH was suspected and confirmed by ultrasound that showed the disruption of internal and external oblique and transverse muscle (6 × 1.5 cm2) and the projection of omentum through the hernia without other associated internal organ injuries (Fig. ). The hematological and biochemical tests were normal. We suggested the admission of the child in our clinic for further clinical monitoring but the parents denied.\nThe reassessment after 2 weeks of rest at home showed an obvious size reduction of the hernia. Because of the significant size difference a MRI evaluation was decided, that confirmed that the disruption size was 3 × 0.7 cm2. In the follow up a month later, the hernia was no longer palpable and the ultrasonography identified a defect <2 mm without herniation.
A 9-year-old male child presented with deceleration injury after falling from a height of 12 feet. He had normal hemodynamic parameters with a pulse of 100/min and a BP of 100/70 mm Hg. Examination revealed a soft abdomen. The FAST exam done was positive. A contrast-enhanced CT (CECT) with oral and IV contrast revealed a completely devascularized right kidney []. As the patient had pain and hematuria, a laparotomy was performed 6 days after injury and the right kidney showed infarction, so a right nephrectomy was done. He had an uneventful postoperative period and went home on postoperative day 6.