Dellaportas Dionysios, Polymeneas George, Dastamani Christina, Kairi-Vasilatou Evi, Papaconstantinou Ioannis
2nd Department of Surgery, University of Athens, Aretaieion Hospital, 76 Vas. Sofias Avenue, 115 28 Athens, Greece.
Case Rep Surg. 2012;2012:528780. doi: 10.1155/2012/528780. Epub 2012 Nov 19.
Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia's contents.
引言。腹膜包涵囊肿是一种非常罕见的起源于间皮的肠系膜囊肿,通常无症状。本文介绍了一例罕见病例,一名82岁的白人女性患有股疝,疝内容物为一个巨大的腹膜包涵囊肿,酷似绞窄性疝。病例报告。患者因右侧腹股沟可触及肿块入院,该肿块在过去几小时内变得疼痛并引起极大不适。体格检查发现腹股沟有一个压痛、紧张且无法回纳的肿块。选择腹股沟手术入路,发现肿块从股环突出。仔细解剖后发现是一个巨大的单房囊肿,内含浆液,可能起源于腹膜。采用麦克维手术修复股环。组织学检查显示为腹膜包涵囊肿。讨论。腹膜包涵囊肿通常无症状,但偶尔会根据其大小出现各种非特异性症状。我们的病例强调,在疝修补过程中保持高度的临床怀疑并进行仔细探查对于正确诊断疝内容物至关重要。