Recurrent Flank Hernia Repair After Penetrating Abdominal Wall Trauma.

Traumatic abdominal flank hernias are rare and challenging but more common than previously recognized. There is no consensus on the management of traumatic flank hernias. The majority of studies have been conducted in the setting of blunt trauma; however, there is a paucity of literature on penetrating trauma. We present the case of a man in his thirties with a persistent left flank hernia after sustaining penetrating abdominal wall trauma from a tree branch two years earlier and undergoing multiple subsequent reconstructive surgeries, including both open and minimally invasive approaches. Flank hernia repair is most commonly performed with mesh and can be accomplished using either an open or minimally invasive approach, either at the time of trauma or in a delayed fashion. In selected patients, definitive repair of traumatic abdominal wall defects may be delayed until acute injuries and contamination have resolved. In this patient, intra-abdominal injuries required immediate operative management, whereas definitive reconstruction of the subsequent symptomatic flank hernia was performed in a delayed fashion.