Sahoo Manash Ranjan, Kumar Anil
Department of General Surgery, SCB Medical College, Cuttack, Odisha, India.
BMJ Case Rep. 2012 Dec 20;2012:bcr2012007919. doi: 10.1136/bcr-2012-007919.
Reduction-en-masse of groin hernia is a problem which is rarely encountered by surgeons and in fact in world literature only 200 cases have been recorded till date. Most of the time this complication is overlooked by surgeons. Hence, surgeons repair the hernia leaving the incarcerated bowel inside which might lead to disaster. We report an unusual case of intestinal obstruction due to reduction-en-masse of a groin hernia because of manual reduction by the patient himself 7 days before, which was missed both by the radiologist as well as by the surgeons. It was found out in diagnostic laparoscopy and managed laparoscopically as well, relieving intestinal obstruction. He was discharged with an advice for definitive repair after 3 weeks. To conclude, in patients of groin hernia presenting in any form of intestinal obstruction we have to keep reduction-en-masse in mind and laparoscopy plays an important role in diagnosis and management.
腹股沟疝整块还纳是外科医生很少遇到的问题，事实上，迄今为止世界文献中仅记录了200例。大多数情况下，这种并发症会被外科医生忽视。因此，外科医生在修补疝时将嵌顿肠管留在体内，这可能会导致灾难。我们报告一例因腹股沟疝整块还纳导致肠梗阻的罕见病例，原因是患者7天前自行手法还纳，放射科医生和外科医生均未发现。通过诊断性腹腔镜检查发现了该情况，并通过腹腔镜进行了处理，解除了肠梗阻。3周后，他出院并得到了进行确定性修补手术的建议。总之，对于出现任何形式肠梗阻的腹股沟疝患者，我们必须考虑到整块还纳的情况，腹腔镜检查在诊断和处理中起着重要作用。
