Bullhorn Lumbar Hernia- A Laparoscopic Repair of Rare Disease

Background: Traumatic abdominal wall hernia (TAWH) is an uncommon complication of blunt trauma, often missed due to intact skin despite disruption of deeper muscle and fascial layers. Bullhorn injury–related TAWH is even rarer, with only a few cases reported worldwide. Case Presentation: A 55-year-old male presented with a reducible swelling over the left lumbar region, one year after sustaining a penetrating bullhorn injury that had been primarily sutured. Clinical examination and imaging (X-ray and NCCT abdomen) confirmed a 3 × 3 cm defect between the ninth and tenth ribs containing omentum and descending colon. The patient underwent elective laparoscopic Intra-Peritoneal Onlay Mesh Repair Plus (IPOM Plus) with primary defect closure using polypropylene sutures and fixation of a composite mesh. Post-operative recovery was uneventful, and no recurrence was noted till 1 year of follow-up. Discussion: TAWH due to bullhorn impact is a rare entity that requires a high index of suspicion and radiological confirmation. Laparoscopic repair allows precise anatomical delineation, tension-free closure, and faster recovery. Conclusion: Laparoscopic IPOM Plus offers a safe and effective minimally invasive option for managing traumatic bullhorn hernias, ensuring durable repair and preservation of abdominal wall integrity.