IMAGES IN EMERGENCY MEDICINE
Traumatic eversion of the umbilicus: what lies beneath?
Department of General Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK
Correspondence to:
Dr N F S Watson, Department of General Surgery, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK; nicholas.watson@nottingham.ac.uk
Accepted 10 January 2008
| The first 150 words of the full text of this article appear below. |
A 40-year-old man presented to casualty after losing control of a high-performance car and colliding with a tree. The driver was wearing a seat belt and was able to extricate himself. No airbags were fitted. On arrival, superficial bruising and abrasions were present across the anterior abdominal wall, with mild abdominal tenderness on palpation. After log-rolling the patient it was noticed that his umbilicus had become everted (fig 1). Subsequent computed tomography scan showed intestinal loops protruding through a defect in the abdominal wall into the subcutaneous space (fig 2). At laparotomy a longitudinal defect was found in the midline through all layers of the anterior abdominal wall, with herniated small bowel loops. The defect was repaired primarily.
Figure 1 Appearance of abdomen following log-roll.
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Figure 2 CT image demonstrating anterior abdominal wall rupture and subcutaneous small bowel loops.
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Rupture of the anterior abdominal wall secondary to blunt trauma is
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