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小儿里脱疝:一例病例报告并文献简要回顾

Littre hernia in childhood: a case report with a brief review of the literature.

作者信息

Pampal Arzu, Aksakal Elif Demirci

机构信息

Department of Pediatric Surgery, Ufuk University, Faculty of Medicine, Ankara, Turkey.

出版信息

Afr J Paediatr Surg. 2011 May-Aug;8(2):221-4. doi: 10.4103/0189-6725.86068.

Abstract

A 3-year-old boy with a right-sided and painful inguinal swelling for the last 2 h was admitted to the emergency department. As there were no apparent peritoneal irritation findings, right-sided incarcerated inguinal hernia was reduced and the patient was scheduled for an elective herniorrhaphy. Perioperatively even though the sac seemed empty, it was opened in order to inspect its content. The adherence of Meckel's diverticulum (MD) to the base of hernial sac was realized and Littre hernia (LH) was diagnosed. The hernia was highly ligated after the wedge resection of the diverticulum and anastomosis. The patient was fed on the second postoperative day and discharged on the third postoperative day. Despite numerous presentations of LH in the adult age group in the literature, there are limited data about the disease in the childhood period. Even though the scarcity of the data, there are some so-called rules for LH in childhood like protruding more common through umbilical hernias, containing heterotopic tissues more frequent than adult age and incarcerating/strangulating more often. The aim of this study is to review the reported LH cases, present a new case and discuss the features of LH in childhood period.

摘要

一名3岁男孩因右侧腹股沟肿胀伴疼痛2小时被收入急诊科。由于没有明显的腹膜刺激征,右侧嵌顿性腹股沟疝得以还纳,患者被安排择期行疝修补术。术中尽管疝囊看似空虚,但仍将其打开以检查内容物。发现梅克尔憩室(MD)与疝囊底部粘连,诊断为里脱疝(LH)。在憩室楔形切除并吻合后,对疝进行了高位结扎。患者术后第二天开始进食,术后第三天出院。尽管文献中有许多关于成人里脱疝的报道,但关于儿童期该病的数据有限。尽管数据稀缺,但儿童里脱疝有一些所谓的规律,如通过脐疝突出更常见、比成人更频繁地包含异位组织以及更常发生嵌顿/绞窄。本研究的目的是回顾已报道的里脱疝病例,呈现一例新病例并讨论儿童期里脱疝的特征。

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