A 60-year-old female presented with obstipation and vomiting following blunt trauma abdomen in the emergency department 2 days back. Patient had fallen from a bullock cart and had sustained blunt trauma abdomen. There was history of obstipation and vomiting. Vitals were stable. She was obese, and abdomen was moderately distended. There was bruising over the skin in right iliac fossa. Abdominal examination revealed a tender reducible mass of 15 × 20 cm2 size in the right iliac fossa. Routine blood investigations were within normal limits. CECT abdomen showed a defect in the anterior abdominal wall above the right iliac crest with herniation of ascending colon and small gut along with avulsed muscle seen in right lumbar region and stranding of subcutaneous fat [Figure and ] There was minimal fluid in the pelvis.\nExploratory laparotomy was performed through an incision over the swelling and findings were a 15-cm wide gap in the aponeurotic part of the external oblique muscle, with small bowel loops along with caecum and ascending colon herniating into the defect. After reduction of herniated contents, abdominal wall defect was repaired primarily with reinforcement by onlay prolene mesh. Patient was discharged in satisfactory condition. On follow-up after 8 months, patient is doing well and asymptomatic.
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.