Justin Brown 23 Oct 2014. 14 yo M transfer from OSH following bicycle crash Hemodynamically stable No helmet, no LOC Contusion with handlebar indention.

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Presentation transcript:

Justin Brown 23 Oct 2014

14 yo M transfer from OSH following bicycle crash Hemodynamically stable No helmet, no LOC Contusion with handlebar indention on LLQ

Hemodynamically stable Abdomen soft LLQ bulge with bike handle indention Mild TTP throughout Exquisitely tender over bulge WBC – 19.9, Afebrile

MT

Rectus External Oblique Spigelian fascia

MT

Traumatic Spigelian Hernia Rare entity 24 reported cases US is gold standard for diagnosis No standard in treatment – Small defects allowed to heal spontaneously – Incarcerated bowel, nonhealing hernias, evidence of perforation indications for repair