重视创伤性腹壁疝的临床诊治

Timely and correct diagnosis and treatment of traumatic abdominal wall hernia

创伤性腹壁疝(traumatic abdominal wall hernia,TAWH)是最严重的腹壁损伤形式之一,发生率低。由于其临床少见,目前对TAWH存在认识上的不足,容易发生误诊误治并导致不良后果。对可能发生TAWH的创伤患者需保持高度的警惕,以CT为代表的影像学检查是诊断和分类TAWH以及评估是否存在其他损伤的首选诊断方式,TAWH治疗时机与方式应根据患者全身状况、是否合并相关的腹内脏器损伤以及腹壁缺损的大小和嵌顿的风险来进行个体化决策。

Traumatic abdominal wall hernia(TAWH)is one of the most serious forms of abdominal wall in-juries.Its low incidence and clinical rarity leads to the current lack of understanding of TAWH,which makes it prone to misdiagnosis and mistreatment,resulting in adverse consequences.For risky trauma patients,the possibility of TAWH should be highly alerted.Imaging examination,represented by CT,is recommended to be the first choice to diagnose and grade TAWH,and to assess whether there are other intra-abdominal injuries.The timing and treat-ment of TAWH should be individualized according to the patient􀆳s general conditions,any combined intra-abdominal organ injuries,size of the abdominal wall defects,and risks of incarceration and strangulation.