Thanapaisan Chaiwetch, Thanapaisal Chaiyut
Division of Surgery, Chiangrai Regional Hospital, 57000, Thailand.
J Med Assoc Thai. 2006 Dec;89(12):2081-5.
To review the patient characteristics and clinical symptoms, intraoperative finding and management, including morbidity and mortality rate of obturator hernia cases.
A retrospective study was performed in 61 patients diagnosed as obturator hernia at Chiangrai Regional Hospital between January 2000 and December 2005.
The incidence of obturator hernia is 61 of 2,828 cases (2.2%) of all hernias, female:male 6.6:1. The mean age was 72.85 years. The mean body weight was 35.72 Kg. Howship-Romberg's sign were positive in eight patients (13.11%). Thirty-five patients (57.38%) were Richter type hernia, left:right side 3:2. Strangulation of bowel occurred in 41 patients (67.21%) Mortality rate was 11.47%. All patients with postoperative complications and all deaths showed bowel strangulation and all were more than 70 years of age.
In the present study, the authors found a high incidence of obturator hernia (2.2% of all hernias) compared with a previous report (0.05%-1.4% of all hernias). This high incident rate might relate to the specific local life style of people in Chiangrai as most patients had a habit of smoking. Chronic obstructive pulmonary disease (COPD), old age, and low body weight were possible contributing factors. Bowel strangulation and age more than 70 years old were associated with morbidity and mortality.
回顾闭孔疝病例的患者特征、临床症状、术中发现及处理情况,包括发病率和死亡率。
对2000年1月至2005年12月在清莱地区医院诊断为闭孔疝的61例患者进行回顾性研究。
闭孔疝在所有疝病例中的发病率为2828例中的61例(2.2%),女性与男性比例为6.6:1。平均年龄为72.85岁。平均体重为35.72千克。8例患者(13.11%)霍希普-罗姆伯格征呈阳性。35例患者(57.38%)为里氏疝,左侧与右侧比例为3:2。41例患者(67.21%)发生肠绞窄。死亡率为11.47%。所有术后出现并发症的患者及所有死亡患者均表现为肠绞窄,且均超过70岁。
在本研究中,作者发现闭孔疝的发病率较高(占所有疝的2.2%),与之前的报告(占所有疝的0.05%-1.4%)相比。这种高发病率可能与清莱地区人们特定的当地生活方式有关,因为大多数患者有吸烟习惯。慢性阻塞性肺疾病(COPD)、老年和低体重可能是促成因素。肠绞窄和年龄超过70岁与发病率和死亡率相关。