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开放性腹股沟疝修补术的晚期并发症:腹膜内补片移位导致的小肠梗阻

Late complication of open inguinal hernia repair: small bowel obstruction caused by intraperitoneal mesh migration.

作者信息

Ferrone Roberto, Scarone Pier Carlo, Natalini Gianni

机构信息

Emergency Surgery Department, Policlinico of Modena, 71 Via del Pozzo, 41100 Modena, Italy.

出版信息

Hernia. 2003 Sep;7(3):161-2. doi: 10.1007/s10029-003-0129-x. Epub 2003 Apr 24.

Abstract

We describe a case of small bowel obstruction due to prosthetic mesh migration. A 67-year-old male, who had undergone prosthetic repair of inguinal hernia 3 years before, was admitted for a mechanical small bowel obstruction. Laparotomy revealed the penultimate ileal loop choked by an adhesion drawing it towards a polypropylene mesh, firmly attached to the parietal peritoneum of the inguinal region. The intestinal loop was released; the mesh was embedded deep with continuous whip suture after folding the parietal peritoneum. The patient was dismissed on the 11th postoperative day surgically healed. The "tension-free" technique is undoubtedly the gold standard for hernia repair. However, it is not free of complications, mostly due to technical errors, of which the surgeon must be aware, both when he is responsible for correcting defects in the wall, as well as when he has to face an occlusion in a patient who has undergone plastic surgery for inguinal hernia.

摘要

我们描述了一例因人工补片移位导致的小肠梗阻病例。一名67岁男性,3年前接受了腹股沟疝人工修复术,因机械性小肠梗阻入院。剖腹探查发现倒数第二个回肠袢被粘连牵拉,朝向一块牢固附着于腹股沟区壁腹膜的聚丙烯补片,导致肠袢受阻。松解肠袢;将壁腹膜折叠后用连续荷包缝合法将补片深埋。患者术后第11天手术愈合出院。“无张力”技术无疑是疝修补的金标准。然而,它并非没有并发症,主要是由于技术失误,外科医生在负责修复腹壁缺损时以及面对接受过腹股沟疝整形手术患者出现梗阻情况时都必须意识到这一点。

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