Camerlinck Michael, Vanhoenacker Filip, De Vuyst Dimitri, Quanten Inge
Department of Radiology, AZ Sint-Maarten, Duffel, Belgium.
Abdom Imaging. 2011 Apr;36(2):170-3. doi: 10.1007/s00261-010-9631-7.
We present a case of a 79-year-old female with a history of pain at the right groin for 9 days. Computer tomography of the pelvis showed herniation of the appendix through the obturator canal with a huge abscess surrounding the right hip joint. Laparotomy was performed and histopathology confirmed a perforated necrotic tip of the herniated appendix. An obturator hernia is a rare hernia of the pelvic floor. It is most common in old, emaciated, multiparous women and can cause groin pain with extension to the medial aspect of the thigh. In case of incarceration of bowel, patients also present with obstruction. Isolated incarceration of the appendix, however, does not cause obstruction. The diagnosis of an obturator hernia is often delayed, due to a non-specific clinical presentation. CT scan may offer the clue to the correct diagnosis and should be performed in case of a possible obturator hernia.
我们报告一例79岁女性,有右侧腹股沟疼痛9天的病史。骨盆计算机断层扫描显示阑尾经闭孔管疝出,右髋关节周围有巨大脓肿。进行了剖腹手术,组织病理学证实疝出阑尾的尖端穿孔坏死。闭孔疝是一种罕见的盆底疝。它在老年、消瘦、多产的女性中最为常见,可引起腹股沟疼痛并延伸至大腿内侧。如果肠管发生嵌顿,患者还会出现肠梗阻。然而,单纯阑尾嵌顿不会导致梗阻。由于临床表现不具特异性,闭孔疝的诊断往往会延迟。CT扫描可能为正确诊断提供线索,对于可能的闭孔疝应进行CT扫描。