PSR carried out the BCVI studies, participated in the sequence alignment and drafted the manuscript. FB participated in the sequence alignment, analysis and interpretation of datas. Selleck Barasertib JA participated in the design of the study and performed the statistical analysis. GG participated in the study of the imagem and award of the angiotomography.

BD participated in the coordination and study of blunt trauma. All authors read and approved the final manuscript.”
“Background Blunt abdominal trauma may cause both crush and shearing effects on healthy abdominal wall and viscera [1]. Acute onset indirect inguinal hernia with testicular dislocation after blunt trauma is rarely reported [2], but, to our knowledge, a case resulting in complete obliteration of the inguinal canal with direct herniation of the abdominal viscera has not been documented. The inguinal ITF2357 clinical trial canal extends from the anterior superior iliac spine to the pubic tubercle. A defect in the posterior wall results in a direct hernia. In our case, all boundaries of the inguinal canal including the floor, posterior, inferior, medial walls and deep and superficial rings were obliterated causing traumatic herniation of the terminal ileum and caecum beneath an attenuated external oblique aponeurosis. We describe the timely reconstruction of the abdominal wall in the inguinal region and the importance of the restoration of normal anatomy with definitive

repair after resolution of swelling and haematoma. Case Presentation A 24 year old man was admitted to hospital following a road traffic accident after his motorcycle collided with a lorry. The speed of collision was 35 mph and abdominal injuries were sustained as a result of impact against the motorcycle

handle bars. On arrival to the Emergency Department the patient was haemodynamically stable and fully conscious. Primary survey revealed a soft abdomen with tenderness, swelling and bruising in right groin and scrotum. There was no previous history of groin hernia. Secondary survey, plain X ray and CT scan confirmed a fracture dislocation of the right shoulder, open fracture of right radius and ulna, multiple PIK3C2G right lung contusions and a new right inguinal hernia. Internal fixation of the upper limb injuries was performed. Reconstruction of the abdominal wall was deferred, in the absence of obvious visceral damage, until resolution of groin swelling and bruising (Fig. 1). Figure 1 Acute onset right groin hernia with bruising and swelling. 12 days after admission, repair of the inguinal hernia was performed. At surgery, the external oblique aponeurosis overlying the inguinal canal was contused inferiorly, and the inguinal ligament was found to be sheared off the full length of its attachment from the anterior superior iliac spine to the pubic tubercle, with all boundaries of the canal obliterated (Fig. 2 &3).