腹腔镜大网膜切除术用于大网膜扭转的术前诊断。
Laparoscopic omentectomy for preoperative diagnosis of torsion of the greater omentum.
作者信息
Abe Tomoyuki, Kajiyama Kiyoshi, Harimoto Norifumi, Gion Tomonobu, Nagaie Takashi
机构信息
Department of Surgery, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka-shi, Fukuoka 820-8505, Japan.
出版信息
Int J Surg Case Rep. 2012;3(3):100-2. doi: 10.1016/j.ijscr.2011.11.004. Epub 2011 Nov 22.
INTRODUCTION
Torsion of the greater omentum is unusual. In most cases, the preoperative diagnosis was difficult due to the non-specific clinical presentation.
PRESENTATION OF CASE
We present a case of greater omental torsion in a 28-year-old man with an untreated right inguinal hernia since childhood. Computed tomography (CT) revealed characteristic signs of omental torsion, which was important in making correct diagnosis. We made correct preoperative diagnosis and performed laparoscopic omentecomy. The greater omentum distal to the twisted part was dark red and showed necrotic change. This case was secondary omental torsion associated with a right inguinal hernia.
DISCUSSION
Omental torsion should always be included in the differential diagnosis of acute abdomen.
CONCLUSION
CT multi-planar reconstruction (MPR) imaging played a particularly important role in making a precise diagnosis. Laparoscopic approach could be useful in both diagnostic and therapeutic intervention. A successful laparoscopic omentectomy was performed in the present case.
引言
大网膜扭转并不常见。在大多数情况下，由于临床表现不具特异性，术前诊断较为困难。
病例介绍
我们报告一例28岁男性大网膜扭转病例，该患者自童年起右侧腹股沟疝未得到治疗。计算机断层扫描（CT）显示了大网膜扭转的特征性征象，这对做出正确诊断很重要。我们做出了正确的术前诊断并进行了腹腔镜大网膜切除术。扭转部位远端的大网膜呈暗红色并显示出坏死改变。该病例为与右侧腹股沟疝相关的继发性大网膜扭转。
讨论
大网膜扭转应始终纳入急腹症的鉴别诊断。
结论
CT多平面重建（MPR）成像在做出精确诊断方面发挥了特别重要的作用。腹腔镜方法在诊断和治疗干预中均可能有用。本病例成功实施了腹腔镜大网膜切除术。
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