A 50-year-old male presented a day after sustaining blunt abdominal injury by a bull horn to the right side of his abdomen. He presented with right lower abdominal swelling. He was hemodynamically stable with a pulse of 82/min and a BP of 130/90 mm Hg. A chest X-ray diagnosed a right simple pneumothorax for which a chest tube was inserted. FAST exam was normal, but contrast CT revealed herniation of bowel through a defect in the anterior abdominal wall []. 3 days after injury, an exploratory laparotomy was done which showed no associated intraperitoneal injury and the hernia was reduced, and the defect reinforced with a mesh. The patient was discharged on postoperative day 7.
A 23-year-old male presented with deceleration injury following an RTA. His hemodynamic parameters were within the normal range; he had a pulse of 80/min and a BP of 110/78 mm Hg. Examination revealed a soft abdomen. The FAST exam was positive, and a CT with oral and IV contrast revealed a completely devascularized spleen. The patient was conservatively managed and started on a liquid diet but developed abdominal pain with associated fever after a week. An exploratory laparotomy was done 8 days after injury, and a splenectomy was done for splenic infarction with abscess formation. He had an uneventful postoperative period and went home on postoperative day 7.