Otowa Yasunori, Kanemitsu Kiyonori, Sumi Yasuo, Nakamura Tetsu, Suzuki Satoshi, Kuroda Daisuke, Kakeji Yoshihiro
Division of Gastro-intestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kusunoki-chou 7-5-2, Chuo-ku, Kobe, 650-0017, Japan,
Surg Today. 2014 Nov;44(11):2187-90. doi: 10.1007/s00595-013-0694-2. Epub 2013 Aug 22.
A 71-year-old female presented to our hospital due to pain from the right hip joint to the lower abdomen. The pain had suddenly appeared and spontaneously disappeared more than 10 times during the past 2 years. She had visited many hospitals, but remained undiagnosed. The patient underwent a computed tomography (CT) scan of the pelvis, and a soft tissue shadow was seen between the external obturator and pectineal muscles. She was diagnosed with a right obturator hernia and underwent elective repair by laparoscopic trans-peritoneal hernioplasty (TAPP). 1 year has passed since the surgery, without any recurrence of the abdominal pain. Obturator hernias are rare, and most cases are found as incarcerated hernias. It is rare to find an obturator hernia without intestinal obstruction, or with the recurrent pain as in our case. We herein report a case in which an obturator hernia was undiagnosed and intermittent pain was experienced for 2 years prior to TAPP, which appears to have successfully treated the hernia.
一名71岁女性因右髋关节至下腹部疼痛前来我院就诊。该疼痛在过去2年中突然出现并自行消失了10多次。她曾就诊于多家医院，但均未确诊。患者接受了骨盆计算机断层扫描（CT），在闭孔外肌和耻骨肌之间可见一个软组织阴影。她被诊断为右侧闭孔疝，并接受了腹腔镜经腹腹膜前疝修补术（TAPP）的择期修复。手术已过去1年，腹痛未再复发。闭孔疝很罕见，大多数病例是以嵌顿疝的形式被发现。像我们这个病例中，发现没有肠梗阻或伴有复发性疼痛的闭孔疝是很罕见的。我们在此报告一例闭孔疝在TAPP术前2年未被诊断且经历间歇性疼痛的病例，该手术似乎已成功治疗了该疝。
