General Surgery, North Middlesex University Hospital, London, UK.
Hernia. 2010 Dec;14(6):651-3. doi: 10.1007/s10029-009-0598-7. Epub 2009 Dec 1.
The diagnosis of an inguinal hernia, be it complicated or uncomplicated, is often simple and straight forward. Rarely, this simple presentation may be the external manifestation of a distant pathology, which is in communication with the inguinal canal through its anatomic relationship. We report a case of ruptured abdominal aortic aneurysm (AAA) that presented as a strangulated left inguinal hernia. To the best of our knowledge, this is the first reported case where the patient was stable on initial presentation, both clinically and biochemically. The only clue for our patient that pointed towards a potential aneurysm was the presence of intra-operative blood in the spermatic cord. We conclude that any patient presenting with symptoms suggestive of a hernia, particularly on the left side, should have a thorough assessment to rule out AAA.
腹股沟疝的诊断，无论是复杂的还是简单的，通常都很简单直接。然而，这种简单的表现可能是远处病变的外在表现，该病变通过其解剖关系与腹股沟管相通。我们报告了一例破裂的腹主动脉瘤（AAA），其表现为绞窄性左侧腹股沟疝。据我们所知，这是首例在初次就诊时患者在临床和生化方面均稳定的病例。我们的患者唯一指向潜在动脉瘤的线索是精索内有术中血液。我们得出结论，任何有疝症状提示的患者，特别是左侧，都应该进行彻底评估以排除 AAA。
