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症状性十二指肠旁右侧疝的诊断与治疗:病例报告。

Diagnosis and treatment of symptomatic right paraduodenal hernia: report of a case.

机构信息

1st Institute of General Surgery, San Giovanni di Dio Hospital, University of Cagliari, Cagliari, Italy,

出版信息

Surg Today. 2014 Jan;44(1):192-6. doi: 10.1007/s00595-012-0483-3. Epub 2013 Jan 18.

Abstract

We report a typical case of right paraduodenal hernia (RPH) and review the literature on the pathogenesis, diagnosis and treatment of this uncommon entity. A 32-year-old woman was hospitalized with acute abdominal cramps, nausea, and vomiting. Computed tomography (CT) findings suggested RPH, which was confirmed by explorative laparoscopy. We performed an open repair by suturing the orifice after reducing the hernia. At her 2-year follow-up, the patient reported complete resolution of her symptoms. Because RPH is rare and its clinical signs are nonspecific, radiological examinations are essential for a correct preoperative diagnosis. CT is currently the most accurate diagnostic tool, but laparoscopy may be necessary to confirm the diagnosis. This hernia can be repaired by simple suturing of the hernial orifice, either laparoscopically or via an open procedure, although several authors consider complete intestinal derotation to be the best option.

摘要

我们报告了一例典型的右十二指肠旁疝(RPH)病例,并复习了有关该罕见疾病的发病机制、诊断和治疗的文献。一名 32 岁女性因急性腹痛、恶心和呕吐住院。计算机断层扫描(CT)结果提示 RPH,经腹腔镜探查证实。我们通过缩小疝口后缝合来进行开放修复。在她的 2 年随访中,患者报告症状完全缓解。由于 RPH 罕见,其临床症状无特异性,因此放射学检查对于正确的术前诊断至关重要。CT 目前是最准确的诊断工具,但腹腔镜检查可能有必要以确认诊断。这种疝可以通过简单地缝合疝口来修复,无论是腹腔镜下还是开放手术,尽管有几位作者认为完全肠旋转是最佳选择。

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