A nearly 7-year-old boy, with no relevant past history, visited our emergency department with abdominal pain and swelling after a fall from his bike. Whilst riding his bike, he had fallen and his abdomen had landed on the handlebar. Immediately after the accident, his mother noticed a swelling where the handlebar had hit his abdomen. They visited the general practitioner on call who subsequently sent him to our emergency department. Apart from pain, he had no other complaints. On physical examination, he seemed to be not ill and he was haemodynamically stable. Examination of the abdomen showed a circular contusion of the skin several centimetres below the umbilicus just on the right of the midline (Fig. ). On palpation, a clear defect of the rectus fascia could be felt. There were no signs of peritonitis suggesting an enteral lesion. He was admitted for observation and discharged the following morning. He was scheduled for surgery 1 week later. During the operation, a skin-line incision was performed over the fascia defect, revealing a rupture of the musculus rectus abdominis, as well as a total rupture of the right rectus fascia (Fig. ). The rectus sheath was closed with a continuous Vicryl suture. The muscle defect was approximated with interrupted Vicryl sutures. The skin was closed intracutaneously. He was discharged the following day and recovered uneventfully.
A 35-year-old male presented with blunt abdominal trauma after an RTA along with injury to left lower limb. His hemodynamic parameters were normal, with a pulse of 100/min and a BP of 110/70 mm Hg. He had generalized abdominal tenderness and guarding. The FAST exam was positive, and X-ray revealed a left shaft of femur fracture. CT with IV contrast revealed no enhancement in both kidneys in the arterial phase suggestive of bilateral renal pedicle injury []. Endovascular stenting of both renal arteries was attempted unsuccessfully the next day after injury. Laparotomy was done 2 days after the injury due to the failure of endovascular stenting, and a right aortorenal artery polytetrafluoroethylene grafting was done on the right side. On the left side, a splenectomy was done, and the splenic artery anastomosed with the left renal artery. Patient underwent repeated dialysis in the postoperative period. His urine output returned to normal but after 4 days, he succumbed due to his injury. summarizes all the cases.