A 45-year-old man, gored by a cow was admitted in emergency department, within 2 h of injury. Patient complained of pain and swelling in the right lower quadrant with localized bruising. Vital signs were stable. On abdominal examination, a tender reducible bulge was present in the right fossa of size 5 × 8 cm2 with underlying fascial defect []. Routine blood tests and chest radiography were normal. USG of the abdomen revealed dilated bowel loops herniating through the defect with minimal fluid in the pelvis.\nOn laparotomy, there was minimal blood stained fluid and a large rent was present in right lower part of the rectus muscle. Ileal loops were reduced, and repair of the mesenteric tear was done. Rest of the intra-abdominal organs were normal. The muscular defects were repaired with absorbable sutures. Postoperatively patient recovered very well. Patient was discharged on 13th postoperative day. On follow-up at 6 months, patient is asymptomatic.
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.