A 40-year-old woman of north Indian origin was brought to the surgical emergency room 2 hours after being attacked by a bull near her home. The animal had struck her with its horns over her right lower abdomen. The patient complained of pain and swelling over the involved area. On examination, her vital signs were normal. There was no associated head, chest, pelvic, or limb injury. A bruise and a visible, ill-defined swelling over the right lumbar and umbilical regions were seen. On palpation, the area was tender, and the swelling decreased on gentle pressure, with gurgling sounds. A defect of 8 cm in maximum diameter could be palpated with irregular, ill-defined margins. On asking the patient to cough, bowel loops could be palpated through the defect. Since the patient was hemodynamically stable and the diagnosis clinically apparent, a transverse laparotomy was performed incorporating the site of injury. An irregular defect was found involving all subcutaneous layers of the abdominal wall, and was repaired with a preperitoneal mesh. There was no associated intra-abdominal injury. The patient's recovery was uneventful and she was discharged on the 3rd postoperative day. She had no recurrence after 1 year of follow-up.
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.