case_images: PMC11257973_01
case_images: (A) Protruding mass seen in the right abdomen after the injury. (B) Abdominal condition of the patient followed up 8 months after surgery.
case_images: fsurg-11-1391533-g001.jpg
case_images: PMC11257973_01_fsurg-11-1391533-g001.jpg
case_images: F1
case_images: Gut sounds were audible at the mass, but it was negative for mobile voiced sounds (Figure 1A). Two weeks after surgery, there were no abnormalities in color ultrasound, and there was no recurrence after 8 months of follow-up (Figure 1B).
case_images: (A) Abdominal ultrasound prompts TAWH before operation. (I: muscle and peritoneal layer rupture caused by trauma; II: intestinal contents in the abdominal cavity protrude subcutaneously through muscle and peritoneal rupture). (B) Abdominal x-ray film before surgery.
case_images: fsurg-11-1391533-g002.jpg
case_images: PMC11257973_01_fsurg-11-1391533-g002.jpg
case_images: F2
case_images: Ultrasound examination showed mixed echoes detected at the right abdominal protrusion, ranging about 7.1 cm x 5.0 cm x 1.1 cm, with clear boundaries and connection to the abdominal cavity, suggesting an abdominal wall hernia (Figure 2A). An abdominal x-ray film showed protrusion of the right portion of the intestinal tract from the right lower abdominal wall (Figure 2B).
case_images: (A) Abdominal wall defect observed during surgery. (B) Intraoperative fascial closure device-assisted abdominal wall repair. (C) Condition of the abdominal wall after repair. (D) Fascial closure device used during surgery.
case_images: fsurg-11-1391533-g003.jpg
case_images: PMC11257973_01_fsurg-11-1391533-g003.jpg
case_images: F3
case_images: Laparoscopic exploration revealed a rupture of the muscle layer of the abdominal wall (including peritoneum, transverse abdominis, internal oblique abdominis, and external oblique abdominis) in the right abdomen, forming a 6-cm-long and 3.5-cm-wide tissue defect (Figure 3A). We attempted to repair the muscular layer defect under laparoscopy, but due to high gap tension and difficulty in operation, we decided to use a fascial closure device (Figure 3D) to assist in suturing the muscle layer. We used the same method repeatedly to insert and guide the suture line through the other marked puncture points (Figure 3B). Finally, each suture was tightened and knotted separately, and the tightness of the muscle layer suture was observed under laparoscopy (Figure 3C).