Kobayashi S, Terasaki M, Kuno T, Okamoto Y, Sakamoto E, Kamiya S, Shinohara T, Asaba Y
Department of Surgery, Shizuoka Saiseikai General Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1999 Aug;100(8):513-6.
A 22-year-old male was admitted to our hospital with abrupt onset of upper abdominal pain. Abdominal US and CT revealed dilatation of the small intestine between the abdominal wall and a lateral segment of the liver. After a diagnosis of an internal hernia through a defect in the falciform ligament, emergency surgery was performed. Laparoscopic investigation showed incarceration of the small intestine in a defect of the falciform ligament. After releasing an incarceration, the hernia orifice was opened to prevent relapse. He was discharged on the 4th postoperative day. Internal hernia through a defect in the falciform ligament is extremely rare, with six reported cases including our own in Japan. Characteristic images of abdominal US and CT enable preoperative diagnosis of this condition. Surgery should be performed at an early stage after onset. In patients with no prior history of surgery, laparoscopic techniques may be useful.
一名22岁男性因突发上腹部疼痛入院。腹部超声和CT显示腹壁与肝脏外侧段之间的小肠扩张。在诊断为通过镰状韧带缺损形成的内疝后,进行了急诊手术。腹腔镜检查显示小肠嵌顿于镰状韧带缺损处。解除嵌顿后,打开疝孔以防止复发。他于术后第4天出院。通过镰状韧带缺损形成的内疝极为罕见,在日本包括我们自己报道的病例在内共有6例。腹部超声和CT的特征性图像有助于术前诊断这种情况。发病后应尽早进行手术。对于无手术史的患者,腹腔镜技术可能有用。