Natsis K, Totlis T, Papadopoulou A L, Apostolidis S, Skandalakis P
Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Mail Box 300, P.O. Box 541 24, Thessaloniki, Greece.
Hernia. 2006 Aug;10(4):347-9. doi: 10.1007/s10029-006-0089-z. Epub 2006 May 17.
Femoral hernia, which is a less common occurrence than inguinal hernia, is not congenital in most cases and is uncommon in young males. It is considered to be more common in females than in males due to an enlarged femoral ring in the former. A case of bilateral femoral hernia in a 64-year-old male cadaver is described within the framework of an anatomical approach. On the right side, the protrusion of the viscus appeared as a small intestine coil, whereas on the left side the protruded viscus appeared as a pelvic colon's appendix appiplocae. On both sides, the protruded viscus was located in front of an aberrant obturator artery, which oriented from the external iliac artery and not from the internal iliac artery as should be the case. The puberal branch of the inferior epigastric artery was absent. The cadaver's medical history and his skin examination excluded an abdominal surgery. In the literature, case reports of bilateral femoral hernia appear only seldom, especially those of male patients who had not undergone inguinal hernia repair surgery. In femoral hernias more often than in other types of hernia, the protruded viscus is strangulated and undergoes a tissue necrosis. Morbidity and mortality for complicated femoral hernia is high. Knowledge of vascular variation such as presented by the cadaver under study is extremely useful to the surgeon because any iatrogenic injury of the aberrant obturator artery during a laparoscopic repair may result in dangerous hemorrhage.
股疝比腹股沟疝少见，多数情况下并非先天性，在年轻男性中也不常见。由于女性股环增大，故认为股疝在女性中比男性更常见。本文在解剖学研究框架内描述了一例64岁男性尸体双侧股疝的情况。右侧，突出的脏器为一段小肠袢；而左侧，突出的脏器为盆腔结肠的阑尾系膜。两侧突出的脏器均位于异常闭孔动脉前方，该动脉起自髂外动脉而非正常情况下的髂内动脉。腹壁下动脉的耻骨支缺如。该尸体的病史及皮肤检查排除了腹部手术史。在文献中，双侧股疝的病例报告很少见，尤其是未接受过腹股沟疝修补手术的男性患者。与其他类型的疝相比，股疝中突出的脏器更常发生绞窄并出现组织坏死。复杂股疝的发病率和死亡率很高。了解本研究尸体所呈现的血管变异情况对外科医生极为有用，因为在腹腔镜修补过程中，异常闭孔动脉的任何医源性损伤都可能导致危险的出血。
