Kulacoglu H, Tumer H, Aktimur R, Kusdemir A
Ataturk Teaching and Research Hospital, Ankara, Turkey.
Acta Chir Belg. 2006 Jan-Feb;106(1):109-11. doi: 10.1080/00015458.2006.11679849.
Internal hernia is an unusal cause of intestinal obstruction. Herniation related to epiploic appendix is a very rare entity. We herein report a case of internal herniation due to an adhesion between epiploic appendixes and the greater omentum. A 71-year-old woman complaining of abdominal pain and intermittent nausea was operated on with the pre-operative diagnosis of intestinal obstruction. Three epiploic appendixes of the left side of the transverse colon and the corresponding part of the greater omentum had created a tunnel and a loop of small bowel 25 cm in length was strangulated. No resection was required after releiving the strangulation. However, the patient died due to massive myocardial infarction in the postoperative period. Internal herniation must be included in the differential diagnosis of patients with acute abdomen or intestinal obstruction. A high index of suspicion with prompt surgical intervention may be the key to the reduction of morbidity and mortality.
内疝是肠梗阻的一种罕见病因。与网膜阑尾相关的疝是一种非常罕见的情况。我们在此报告一例因网膜阑尾与大网膜粘连导致的内疝病例。一名71岁女性，因腹痛和间歇性恶心就诊，术前诊断为肠梗阻并接受了手术。横结肠左侧的三个网膜阑尾与大网膜的相应部分形成了一个通道，一段25厘米长的小肠袢被绞窄。解除绞窄后无需进行切除。然而，患者在术后因大面积心肌梗死死亡。内疝必须纳入急腹症或肠梗阻患者的鉴别诊断中。高度怀疑并及时进行手术干预可能是降低发病率和死亡率的关键。
