Department of Surgery, Kings College Hospital, Denmark Hill, SE5 9RS, London.
World J Emerg Surg. 2010 Jun 10;5:16. doi: 10.1186/1749-7922-5-16.
We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers.To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.
我们报告了一例创伤性腹股沟疝，其发生于道路交通事故后的钝性腹部创伤，描述了其发生的情况和修复技术。患者发生多处上肢骨折，并出现右腹股沟和阴囊的急性肿胀。CT 扫描证实急性形成创伤性腹股沟疝。手术修复被推迟到急性肿胀和皮下血肿消退。手术指征为内脏绞窄或缺血的潜在风险，患者在咳嗽时感到不适。手术时，腹股沟管完全闭塞，肠管和网膜直接位于薄弱的腹外斜肌腱膜下方。在逐层重建腹股沟韧带和管后，采用改良的 prolene 网片疝修补术。据我们所知，这是首例记录到的由于钝性腹部创伤导致的急性直接腹股沟疝形成，其腹股沟管完全中断。手术修复概述了在生理上从急性创伤中恢复且解剖结构因受伤而扭曲的患者中恢复正常解剖结构的原则。
