Haraguchi Masashi, Matsuo Shigetoshi, Kanetaka Kengo, Tokai Hirotaka, Azuma Takashi, Yamaguchi Satoshi, Kanematsu Takashi
Department of Surgery, Nagasaki Prefectural Shimabara Hospital, Nagasaki, Japan.
Ann Acad Med Singap. 2007 Jun;36(6):413-5.
Obturator hernia is an important cause of small bowel obstruction and is associated with difficult diagnosis and high mortality.
We reviewed 22 cases of intestinal obstruction due to obturator hernia that necessitated surgical intervention over the last 17 years and evaluated the changes in the number of patients based on the census data.
All cases were elderly females. The Howship-Romberg sign was present in 15 patients (68%). Computed tomography (CT) correctly diagnosed 13/15 (87%) of cases in which it was performed prospectively. The median time to surgery was 7.5+/-5.2 days for those patients with bowel resection, compared to 0.8+/-1.3 days for those without (P <0.05). The number of patients with obturator hernia has increased with an ageing society.
The rising incidence of obturator hernia is probably linked to an ageing society. CT of the pelvis was helpful in obtaining the correct diagnosis. The shorter the delay between admission and surgery, the lower the bowel resection rate. Laparotomy at an early stage is recommended in such patients as it leads to reduced morbidity and mortality.
闭孔疝是小肠梗阻的一个重要原因，且与诊断困难及高死亡率相关。
我们回顾了过去17年中因闭孔疝导致肠梗阻而需手术干预的22例病例，并根据人口普查数据评估了患者数量的变化。
所有病例均为老年女性。15例患者（68%）出现霍希普-龙伯格征。计算机断层扫描（CT）对前瞻性检查的15例病例中的13例（87%）做出了正确诊断。接受肠切除的患者手术中位时间为7.5±5.2天，未接受肠切除的患者为0.8±1.3天（P<0.05）。随着社会老龄化，闭孔疝患者数量有所增加。
闭孔疝发病率上升可能与社会老龄化有关。骨盆CT有助于做出正确诊断。入院至手术的延迟时间越短，肠切除率越低。建议此类患者早期行剖腹手术，因为这可降低发病率和死亡率。
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