Online Exclusives
Traumatic disruption of the abdominal wall: Lap-belt injuries in children
Traumatic abdominal wall hernia (TAWH) from high speed mechanism is a unique finding in adult trauma, and exceedingly rare in pediatrics. The majority of reports are of low-speed “handlebar” hernias associated with direct injury by bicycle handlebars. We report a series of three pediatric patients in motor vehicle collisions (MVC) who experienced TAWH by lap-belt and associated intra-abdominal injuries necessitating immediate operative intervention. Different operative approaches were used in each case to manage the varying types of disruptions.Management of postdural puncture headache with epidural saline patch in a 10-year-old child after inguinal hernia repair: A case report
Spinal anesthesia (SA) is becoming increasingly popular among pediatric anesthetists. Postdural puncture headache (PDPH) has been reported in children. PDPH generally spontaneously resolves within a few days with bed rest and nonopioid analgesics, but it may last for several days. If the symptoms persist, an epidural blood patch is considered as an effective treatment. We describe the successful use of an epidural saline patch in a 10 year-old child with PDPH who did not respond to conservative treatment.Conservative management of a traumatic abdominal wall hernia after a bicycle handlebar injury (case report and literature review)
‘Handlebar hernia' is the name given to a specific type of traumatic abdominal wall hernia (TAWH). It is an uncommon injury, caused by impact of the abdominal wall against a blunt object, often bicycle handlebars. We present a case of handelbar hernia, discuss its investigation and treatment and suggest that immediate surgical repair may not always be required.An exceptional cause of intestinal obstruction in a 2-year-old boy: strangulated hernia of the ileum through Winslow’s foramen
The case of a 2-year-old boy suffering from a strangulated ileal herniation through Winslow's foramen into the lesser sac is reported. He presented an abdominal pain of sudden onset 16 hours previously. The clinical examination, abdominal x-ray, and sonography were not helpful in the assessment of the diagnosis of internal hernia, which was evoked by the computed tomography. At laparotomy, approximately 30 cm of the strangulated ileum was reduced through Winslow's foramen. Fifteen centimeters of the ileum was gangrenous and thus resected with an end-to-end anastomosis.
