Bátorfi József, Simon Eva, Parti Krisztina, Horváth Alexandra, Bajsz András, Horváth Tibor
Nagykanizsa Megyei Jogú Város Kórháza, Általános Sebészeti Osztály, Nagykanizsa Szekeres.
Magy Seb. 2012 Feb;65(1):14-8. doi: 10.1556/MaSeb.65.2012.1.3.
The occult inguinal hernia in athletes represents a distinct entity as well as a part of a syndrome known as PIPS (public inguinal pain syndrome). It may be relatively difficult to identify the possible source of inguinal pain, since the spectrum is so wide that it can overlap various medical subspecialties.
This study includes 14 cases of athletes (11 football players) with suspicion of occult inguinal hernia. All of them complained of suprapubic pain on physical activity which was relieved at rest. No hernia was found on physical examination in either patient. Ultrasonography of the region demonstrated protrusion of the posterior abdominal wall by increased intraabdominal pressure (such as coughing) in 12 cases. Diagnostic laparoscopy was performed in every case, and we found 13 medial and 1 femoral hernia, i.e. a hernia was identified in all patients. Laparoscopic hernia repair with TAPP (transabdominal preperitoneal) technique was carried out in every case.
Patients were discharged 2-3 days after surgery without any postoperative complication. A gradual increase in physical activity was advised up to the limit of complaints commencing 7-10 days later. All patients could return to competitive sports after 4-6 weeks.
Differential diagnosis of inguinal pain in athletes includes occult inguinal hernia, which can be diagnosed with laparoscopy and TAPP repair can be carried out at the same time, if needed, to fix it.
运动员隐匿性腹股沟疝是一种独特的病症，也是被称为耻骨腹股沟疼痛综合征（PIPS）的综合征的一部分。腹股沟疼痛的可能来源相对难以确定，因为其范围很广，可能会与多个医学亚专业领域的情况重叠。
本研究纳入了14例疑似隐匿性腹股沟疝的运动员（11名足球运动员）。他们均主诉在体育活动时耻骨上区疼痛，休息时缓解。体格检查均未发现疝。该区域的超声检查显示，12例患者在腹内压增加（如咳嗽）时出现后腹壁突出。所有病例均进行了诊断性腹腔镜检查，我们发现了13例内侧疝和1例股疝，即所有患者均确诊为疝。所有病例均采用经腹腹膜前修补术（TAPP）进行腹腔镜疝修补。
患者术后2 - 3天出院，无任何术后并发症。建议逐渐增加体育活动量，直至7 - 10天后出现疼痛症状的上限。所有患者在4 - 6周后均可恢复竞技运动。
运动员腹股沟疼痛的鉴别诊断包括隐匿性腹股沟疝，可通过腹腔镜进行诊断，如有需要可同时进行TAPP修补以修复疝。
