Handlebar hernia with intra-abdominal extraluminal air presenting as a novel form of traumatic abdominal wall hernia: Report of a case

An 18-year-old male was admitted to our Emergency Department with a traumat ic abdominal wall hernia (TAWH) of the left lower quadrant (LLQ) after suff ering hypogastric blunt injury and urogenital lacerations in a motorcycle a ccident. Upright chest X-ray showed a small amount of right infradiaphragma tic free sir, and a computed tomographic (CT) scan demonstrated an abdomina l wall hernia. At surgery, no impairment was found in the digestive tract, and an abdominal herniorrhaphy tvas performed. It is suggested that the fre e air had passed through a connection between the scrotal laceration and th e contralateral abdominal defect via the subcutaneous space and was palpate d as emphysema. This is a new type of TAWH, which suggests that blunt abdom inal trauma may result in negative pressure in the subcutaneous and periton eal cavity, and this could reflect the pathophysiology of TAWH.