Hirano Yasumitsu, Oyama Kaeko, Nozawa Hiroshi, Hara Takuo, Nakada Koichi, Hada Masahiro, Takagi Takeshi, Hirano Makoto
Department of Surgery, Kouseiren Takaoka Hospital 5-10, Eiraku-cho, Takaoka, Toyama 933-8555, Japan.
World J Gastroenterol. 2006 Jan 28;12(4):662-4. doi: 10.3748/wjg.v12.i4.662.
We report a case of surgically proved left-sided torsion of the greater omentum that caused secondary by untreated inguinal hernia. Case A 36-year-old man presented to our hospital with abdominal pain. He had been diagnosed with a left inguinal hernia, but he had not received any treatments. Contrast-enhanced computed tomography (CT) of the abdomen showed a large fat density mass below the Sigmoid colon and left inguinal hernia with incarcerated fat. Exploratory laparotomy revealed torsion of the greater omentum with small bloody ascites. The greater omentum was twisted into one and a half circles and entered into a left inguinal hernia. An omentectomy with a repair of left inguinal hernia was performed. A resected omentum was submitted for pathological examination, which showed hemorrhagic infarction. Omental torsion is a rare cause of acute abdominal pain but should be included in the differential diagnoses of acute abdomen, especially in patients with untreated inguinal hernia.
我们报告一例经手术证实的大网膜左侧扭转病例,该扭转由未治疗的腹股沟疝继发引起。病例A为一名36岁男性,因腹痛前来我院就诊。他曾被诊断为左侧腹股沟疝,但未接受任何治疗。腹部增强计算机断层扫描(CT)显示乙状结肠下方有一个大的脂肪密度肿块以及伴有嵌顿脂肪的左侧腹股沟疝。剖腹探查发现大网膜扭转并伴有少量血性腹水。大网膜扭转了一圈半并进入左侧腹股沟疝。遂行大网膜切除术并修补左侧腹股沟疝。切除的大网膜送病理检查,结果显示为出血性梗死。大网膜扭转是急性腹痛的罕见原因,但在急性腹痛的鉴别诊断中应予以考虑,尤其是在未治疗的腹股沟疝患者中。