Pediatric traumatic spiegelian hernia, not always a handlebar hernia: A case report

Abstract

Introduction and importance

Traumatic abdominal wall hernia is rare in children, and traumatic Spiegelian hernia is exceptional. Most of them occur due to a handlebar accident in older children. This report concerns a case of a toddler with a rare mechanism and location.

Case presentation

We report a case of a 28-month-old girl who was hit by a car and immediately presented at our institution with a right upper quadrant 5-cm defect traumatic Spiegelian hernia associated with a congenital umbilical hernia and no other associated lesions, as confirmed by a computed tomography scan. Three weeks later, the defect along the semilunar line was still palpable (3 cm), so open tissue repair was performed for both hernias, with good outcomes four months postoperatively.

Clinical discussion

When traumatic Spiegelian hernia occurs mainly due to handlebar accidents, it is rare in children under 5-year-olds, with a different mechanism. The lesion seems more frequent in the right upper quadrant in this population.

Conclusion

Traumatic Spiegelian hernia can occur in toddlers, with a different mechanism and location compared to older children. Computed tomography is essential to explore associated intraabdominal injuries. Despite the tendency for the defect size reduction, repair must be performed for palpable defects.