Abdominal wall injuries occurring after blunt trauma: incidence and grading system

Am J Surg. 2009 Mar;197(3):413-7. doi: 10.1016/j.amjsurg.2008.11.015.


Background: Traumatic abdominal wall injuries (AWIs) are being increasingly recognized after blunt force injury.

Methods: All available abdominal/pelvic computed axial tomography (CAT) scans of blunt trauma patients evaluated at our level I trauma center from January 2005 to August 2006 were reviewed for the presence of AWI. AWI was graded using a severity-based numeric system. AWI grade was then compared with variables from a prospectively maintained trauma registry.

Results: Of 1,549 reviewed CAT scans, 9% showed AWI (grade I = 53%, grade II = 28%, grade III = 9%, grade IV = 8%, and grade V = 2%). There was no association between AWI and seatbelt use, Injury Severity Score, weight, or need for abdominal surgery.

Conclusions: AWI occurs in 9% of blunt trauma patients undergoing abdominal/pelvic CAT scans. The incidence of herniation on CAT at presentation after blunt trauma is .2%, and the incidence of patients at risk of future hernia formation is 1.5%. AWI can be effectively cataloged using a straightforward numeric grading system.

MeSH terms

  • Abdominal Injuries / classification*
  • Abdominal Injuries / diagnostic imaging
  • Abdominal Injuries / epidemiology*
  • Abdominal Injuries / etiology
  • Abdominal Wall*
  • Adult
  • Female
  • Humans
  • Incidence
  • Male
  • Tomography, X-Ray Computed
  • Trauma Centers
  • Trauma Severity Indices
  • Wounds, Nonpenetrating / complications