Hall C, Hall P N, Wingate J P, Neoptolemos J P
Department of Surgery, Dudley Road Hospital, Birmingham, UK.
Br J Surg. 1990 Aug;77(8):902-6. doi: 10.1002/bjs.1800770820.
Outpatient herniography as a means of confirming or refuting the presence of an occult abdominal wall hernia was performed in 50 symptomatic patients, including 13 who had previously undergone hernia repair. Altogether 30 occult hernias were detected in 27 patients, only one of which was considered to be unrelated to the presenting symptoms. On the basis of herniography, 17 patients were spared surgical exploration and, of these 17, 16 obtained a good result. One further patient with a clinically apparent hernia on one side but with contralateral symptoms was spared unnecessary surgery because the contralateral side was radiologically normal. There was one false negative and no false positive examinations. There were three minor complications: two cases of sigmoid colon puncture and one of abdominal wall haemorrhage (all managed conservatively). There were two technical failures. These results support the Scandinavian experience that herniography has a useful role in the management of patients who may have occult hernias as the underlying cause of abdominal wall symptoms.
对50例有症状的患者进行了门诊疝造影，以确认或排除隐匿性腹壁疝的存在，其中包括13例先前接受过疝修补术的患者。共在27例患者中检测到30例隐匿性疝，其中只有1例被认为与当前症状无关。根据疝造影结果，17例患者免于手术探查，这17例患者中有16例取得了良好效果。另有1例患者一侧临床可见疝但对侧有症状，因对侧放射学检查正常而避免了不必要的手术。有1例假阴性检查，无假阳性检查。有3例轻微并发症：2例乙状结肠穿刺和1例腹壁出血（均保守处理）。有2例技术失败。这些结果支持了斯堪的纳维亚的经验，即疝造影在可能以隐匿性疝为腹壁症状潜在病因的患者管理中具有重要作用。
