Traumatic Flank Hernias: Acute and Chronic Management

Background: Traumatic flank hernias are increasingly recognized as occurring after severe blunt injury. To clarify the role and timing of operative therapy, we review here our recent experience.

Methods: A prospectively maintained database at Oklahoma's only level I trauma center was reviewed to identify all patients presenting with traumatic flank hernias.

Results: During the period from July 2001 through February 2007, 25 patients (.2% of all blunt trauma patients) had traumatic flank hernias. The average age was 36.4 years (range 13 to 66), and all cases but 1 were related to motor vehicle crashes. All patients had at least 1 associated injury. Repairs were done by standardized approach. Eleven patients underwent immediate surgery; 8 underwent delayed repair; and 3 underwent late repair (range 4.5 to 10 years after injury). The other 3 patients were managed expectantly. There was 1 mortality and 3 recurrences. Length of stay for acute trauma ranged from 5 to 49 days and was dependent on the severity of associated injuries. Follow-up of 21 patients ranged from 7 to 710 days.

Conclusions: Traumatic flank hernias are rare but more common than previously recognized. Prompt recognition, proper timing, and technique are key to successful outcomes.