Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, Japan.
Surg Today. 2010;40(2):171-5. doi: 10.1007/s00595-009-4010-0. Epub 2010 Jan 28.
A 28-year-old man with no previous history of abdominal surgery presented at a local hospital with abdominal pain. He was diagnosed to have an intestinal obstruction and was treated conservatively. However, the symptoms persisted, and he was thereafter referred to this hospital. Plain abdominal radiographs demonstrated small-bowel gas. A computed tomographic scan of the abdomen disclosed wall thickening of an edematous, fluid-filled ileum. An exploratory laparotomy was performed to determine the cause of the intestinal obstruction. The ileum had herniated into the intersigmoid fossa, 100 cm proximal to the ileocecal valve, and the patient was diagnosed to have an intersigmoid hernia. Since the incarcerated portion of the small bowel was viable, reduction of the hernia and closure of the defect in the sigmoid mesocolon were performed. The postoperative course was uneventful. A sigmoid mesocolon hernia is an uncommon condition. This report presents a case of intersigmoid hernia and a review of 60 cases of sigmoid mesocolon hernia reported in Japan.
一位 28 岁的男性,既往无腹部手术史,因腹痛就诊于当地医院。他被诊断为肠梗阻,并接受了保守治疗。然而,症状持续存在,随后被转至我院。腹部平片显示小肠积气。腹部 CT 扫描显示肠壁水肿、充满液体的回肠增厚。行剖腹探查术以确定肠梗阻的原因。回肠疝入乙状结肠间隐窝,距离回盲瓣 100cm 处,诊断为乙状结肠间疝。由于小肠嵌顿部分存活,行疝复位和乙状结肠系膜缺损修补术。术后恢复顺利。乙状结肠系膜疝是一种罕见的疾病。本报告介绍了一例乙状结肠间疝,并复习了日本报道的 60 例乙状结肠系膜疝病例。