Paper Title: Traumatic Abdominal wall hernia with incidental Meckel diverticulum and Mega appendix: A Case Report
Authors: Igwe P.O, Dodiyi-Manuel A, Adotey J.M, Okeke C.J
Background: Traumatic abdominal wall hernia is uncommon among Africans though the prevalence of both penetrating and blunt abdominal injuries is high. This condition which was first described by Selby in 1906 has paucity of reports in literature. Open and laparoscopic approaches have been reported to have been used in repair Aim: This is to report a case of traumatic abdominal wall hernia, incidental Meckel’s diverticulum, mega appendix and review of approach to management. Case Report: A 27 year old male presented with a history of left sided anterior abdominal wall swelling and generalized abdominal pain, following a stab wound on the left lower chest wall. There was no abdominal distension. On examination, blood pressure was 110/70 mmHg, pulse was 90 beats per minute, and there was a soft, localized tender mass on the left lower part of the umbilical region, associated with visible peristalsis. Working diagnosis was penetrating abdominal injury with abdominal wall hernia. He had emergency exploratory laparotomy following resuscitation. The findings were: Rectus abdominus facial defect with ileal herniation and multiple perforation, Meckel’s diverticulum, mega appendix with fecolith and haemoperitoneum. Then a wedge resection and closure of the perforations, appendectomy, diverticulectomy and reduction and repair of hernia with interrupted non absorbable sutures were done. His out-patient follow-up has been uneventful. Conclusion: The diagnosis of traumatic abdominal wall hernia can be made clinically. The finding of Meckel’s diverticulum and Mega-appendix is rare in our environment.