Ishizu K, Seyama A, Nakayama T, Konishi M, Joko K, Takihara H, Sakatoku J, Tanaka K
Department of Urology, Nagato General Hospital.
Hinyokika Kiyo. 1992 Apr;38(4):455-8.
A 72-year-old man complained of right hemiscrotal swelling and pollakisuria which had appeared 3 days after herniorrhaphy. On physical examination, a large mass in the right scrotum did not transmit light nor shrink upon pressure application. The concentrations of blood urea nitrogen and creatinine in the fluid obtained by puncture from the scrotal mass were high. Cystography demonstrated influx of contrast media into the scrotal mass from the bladder. From these findings, diagnosis was made as herniation of the bladder. An operation was performed through inguinoscrotal incision. The herniated bladder, to which peritoneum was laterally adherent, was incarcerated. The hernia ring, which was located medially to the suture line of previous herniorraphy, had strangulated the herniated bladder. The bladder wall was edematous and the mucosa was dark red. These findings suggested that the blood circulation in the herniated bladder had been disturbed for a relatively long time. Resection of the herniated bladder with the adherent peritoneum was performed in addition to hernia repair. Incomplete herniorrhaphy may be one of the causes of herniation of the bladder in our case.
一名72岁男性主诉在疝修补术后3天出现右侧阴囊肿胀和尿频。体格检查发现,右侧阴囊内有一巨大肿物,不透光且按压不缩小。经阴囊肿物穿刺抽取的液体中血尿素氮和肌酐浓度较高。膀胱造影显示造影剂从膀胱流入阴囊肿物。根据这些发现,诊断为膀胱疝。通过腹股沟阴囊切口进行了手术。疝出的膀胱与腹膜外侧粘连,已发生嵌顿。疝环位于先前疝修补术缝线内侧,已绞窄疝出的膀胱。膀胱壁水肿,黏膜呈暗红色。这些发现提示疝出膀胱的血液循环已受干扰较长时间。除疝修补外,还进行了疝出膀胱及粘连腹膜的切除术。在我们的病例中,疝修补不完全可能是膀胱疝形成的原因之一。