Repair of a traumatic flank hernia: A case report and literature review

Abstract

Lumbar and flank hernias are rare, and the ideal repair approach remains debated. There have been fewer than 1500 lumbar/flank hernias reported in the literature, and cases due to traumatic injury are even rarer. In this case report, we describe a traumatic flank hernia in a patient who was pinned between two motor vehicles, an accident that resulted in avulsion of the oblique muscles from the iliac crest. Additional traumatic injuries included bucket-handle injuries of the ileum requiring small bowel resection, and multiple orthopedic injuries. After initial small bowel resection and resuscitation, subsequent imaging demonstrated the new anastomosis herniating into an 11 cm × 6 cm flank hernia with avulsion of the oblique muscles. The hernia was repaired primarily with iliac crest bone anchors and no mesh placement. Recovery was uncomplicated, and the patient was discharged to an acute rehabilitation unit. At 12 months post-repair, there is no recurrence.