Tekin Ahmet, Küçükkartallar Tevfik, Aksoy Faruk, Vatansev Celalettin, Belviranli Metin, Tekin Sakir, Yol Serdar, Sahin Mustafa, Tavli Sakir, Kartal Adil
Department of General Surgery, Meram Medical Faculty, University of Selcuk, Konya, Turkey.
Med Princ Pract. 2008;17(5):400-3. doi: 10.1159/000141505. Epub 2008 Aug 6.
To evaluate internal herniation as a rare cause of intestinal obstruction.
Files of 18 cases, operated due to internal herniation between 2000 and 2006 at Selcuk University, Meram School of Medicine, General Surgery Department, were reviewed retrospectively. Sixteen patients (88.8%) were male (mean age: 58.2 years; range: 42-67) and 2 were female (mean age: 56.5 years; range: 52-61).Cases were grouped according to the location of internal herniation, and the clinical findings and applied treatment strategies were evaluated.
All patients were taken into surgical operation after preoperative preparations were completed. Findings were as follows: 6 cases of paraduodenal internal herniation, 4 of internal herniation through a defect in the terminal mesoileum, 2 of herniation through a defect in the falciform ligament, 2 of herniation through a defect in the omentum majus, 1 of herniation to the recessus over the bladder, 2 of herniation through a defect in the transverse mesocolon and 1 iatrogenically caused internal herniation through a defect in the mesojejunum.
In an adult patient with findings of intestinal obstruction, diagnosis is difficult. Most cases presented to date are incidental findings during laparotomy, and surgical treatment is necessary.
评估内疝作为肠梗阻罕见病因的情况。
回顾性分析2000年至2006年间在塞尔丘克大学梅拉姆医学院普通外科因内疝接受手术的18例患者的病历。16例患者（88.8%）为男性（平均年龄：58.2岁；范围：42 - 67岁），2例为女性（平均年龄：56.5岁；范围：52 - 61岁）。根据内疝的位置对病例进行分组，并评估临床发现及应用的治疗策略。
所有患者在完成术前准备后均接受了手术。结果如下：十二指肠旁内疝6例，经回肠末端系膜缺损的内疝4例，经镰状韧带缺损的内疝2例，经大网膜缺损的内疝2例，疝入膀胱上隐窝1例，经横结肠系膜缺损的内疝2例，以及经空肠系膜缺损医源性导致的内疝1例。
对于有肠梗阻表现的成年患者，诊断困难。迄今为止，大多数病例是在剖腹手术中偶然发现的，手术治疗是必要的。
