Kouraklis Gregory, Kouskos Efstratios, Glinavou Andromachi, Raftopoulos John, Karatzas Gabriel
Second Department of Propedeutic Surgery, Medical School University of Athens, Athens, Greece.
Surg Today. 2003;33(9):707-8. doi: 10.1007/s00595-002-2552-5.
Perforation of the large bowel due to benign or malignant disease in an inguinal hernia is very rare, but should be considered as a potential cause of strangulated hernias. A 79-year-old man with a 2-day history of scrotal swelling and pain in the left side associated with fever and chills was brought to our Emergency Department, where he was classified as American Society of Anesthesiologists IVE. A large left incarcerated scrotal hernia was diagnosed and surgical exploration was performed using local infiltration anesthesia. A standard oblique inguinal incision was made, revealing perforation of the sigmoid colon due to cancer. A 40-cm segmental resection of the sigmoid colon was done, and a double-barrel colostomy was made through the inguinal incision. This surgical strategy involving construction of a double-barrel colostomy through the inguinal hernia incision could be an alternative method of managing such critically ill patients.
腹股沟疝因良性或恶性疾病导致的大肠穿孔非常罕见，但应被视为绞窄性疝的潜在病因。一名79岁男性，有2天左侧阴囊肿胀、疼痛伴发热、寒战的病史，被送至我院急诊科，在那里他被分类为美国麻醉医师协会IV E级。诊断为左侧巨大嵌顿性阴囊疝，并采用局部浸润麻醉进行手术探查。做了一个标准的斜形腹股沟切口，发现乙状结肠因癌症穿孔。对乙状结肠进行了40厘米的节段性切除，并通过腹股沟切口做了双腔结肠造口术。这种通过腹股沟疝切口构建双腔结肠造口术的手术策略可能是治疗此类重症患者的一种替代方法。
