Takayama Satoru, Hirokawa Takahisa, Sakamoto Masaki, Takahashi Hiroki, Yamamoto Minoru, Sato Mikinori, Manabe Tadao
Department of Gastroenterological Surgery, Nagoya City University, 1 Kawasumi, Nagoya 467-8601, Japan.
Surg Today. 2007;37(5):437-9. doi: 10.1007/s00595-006-3397-0. Epub 2007 Apr 30.
We report the case of a 94-year-old woman who presented with signs of a small bowel obstruction many years after an appendectomy. Abdominal computed tomography (CT) scan showed discontinuity of the small bowel at a point next to the uterus. We made a provisional diagnosis of an internal hernia through a defect in the broad ligament and performed laparoscopic exploration, which revealed a viable ileal loop incarcerated through the broad ligament. Thus, CT scan may be useful for diagnosing this type of defect preoperatively, whereby open surgery can be avoided.
我们报告了一例94岁女性患者的病例,该患者在阑尾切除术后多年出现小肠梗阻症状。腹部计算机断层扫描(CT)显示小肠在子宫旁某点处连续性中断。我们初步诊断为通过阔韧带缺损形成的内疝,并进行了腹腔镜探查,结果发现一个存活的回肠袢被嵌顿在阔韧带中。因此,CT扫描可能有助于术前诊断此类缺损,从而避免开放手术。