DIRECT ABDOMINAL HERNIA OF TRAUMATIC ORIGIN.

Abstract

This case is interesting, perhaps more in its origin than in the lesion produced, though none the less instructive. <h3>Patient.</h3> —A man, aged 32, laborer, was employed with a wheelbarrow on a scaffolding six feet from the ground, when a misstep caused him to fall, the wheelbarrow following and the handle striking him in the right iliac region. <h3>Examination.</h3> —When first seen, a short time later, there was a soft hemispherical mass, 6 cm. in elevation and 8 cm. in diameter, in the region of the injury, with but slight abrasion and no discoloration of the overlying skin. Extreme pain prohibited manipulation, but as the diagnosis was apparent the man was sent to the hospital. There, when placed in a recumbent posture, the mass receded, and a hiatus could be felt in the supporting structures of the abdominal wall. In fact, the margin of the lacerated aponeurosis was plainly palpable.