Agbakwuru E A, Alatise O I, Adisa A O, Salako A A, Adesunkanmi A R K
Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
Niger J Clin Pract. 2009 Jun;12(2):157-61.
The traditional anatomical and surgical teaching is that any hernia with the neck above and medial to the pubic tubercle are inguinal. Present day surgical authors and teachers mostly adhere to this teaching but observe a difference in this relationship in clinical demonstrations. This confuses most medical students and surgical residents. This all-important clinical teaching should hence be revisited. Hence this study was to ascertain and validate clinically the true relationship of pubic tubercle and the neck of groins hernia.
Aprospective observational study.
Surgical Outpatient Clinic of Wesley Guild Hospital, Ilesa Unit of the Obafemi Awolowo University Teaching Hospital Complex, Nigeria.
Consecutive patients seen in the clinic with uncomplicated groin hernias were studied from January 1993 to December 2004. Examinations were done to ascertain the relationship of the groin hernias to the pubic tubercle.
96.8% of inguinal hernias have their necks above and lateral to pubic tubercle while all femoral hernia had their necks below and lateral to the pubic tubercle.
Location above or below the pubic tubercle should be used as the sole difference between femoral and inguinal hernias in clinical demonstrations. More observations and inguinal dissections will be necessary for further clarification.
传统的解剖学和外科学教学认为，任何疝囊颈部位于耻骨结节上方和内侧的疝均为腹股沟疝。当今的外科作者和教师大多遵循这一教学观点，但在临床示教中发现这种关系存在差异。这使大多数医学生和外科住院医师感到困惑。因此，这一至关重要的临床教学内容应重新审视。故而本研究旨在临床确定并验证耻骨结节与腹股沟疝疝囊颈部的真实关系。
前瞻性观察研究。
尼日利亚奥巴费米·阿沃洛沃大学教学医院综合体伊莱萨分院卫斯理公会医院外科门诊。
对1993年1月至2004年12月在该诊所就诊的连续患有单纯性腹股沟疝的患者进行研究。通过检查确定腹股沟疝与耻骨结节的关系。
96.8%的腹股沟疝疝囊颈部位于耻骨结节上方和外侧，而所有股疝的疝囊颈部位于耻骨结节下方和外侧。
在临床示教中，耻骨结节上方或下方的位置应作为股疝和腹股沟疝的唯一区别。需要更多观察和腹股沟解剖以进一步明确。
