Li Bin, Assaf Akram, Gong Yun-Guo, Feng Lian-Zhong, Zheng Xue-Yong, Wu Chao-Neng
Bin Li, Lian-Zhong Feng, Xue-Yong Zheng, Department of General Surgery, the Second Hospital of Jiaxing, Jiaxing 314000, Zhejiang Province, China.
World J Gastroenterol. 2014 May 21;20(19):5924-9. doi: 10.3748/wjg.v20.i19.5924.
Transmesosigmoid hernia has previously been considered as a rare condition. The clinical symptoms can be nonspecific. Here, we report a case of acute intestinal obstruction because of transmesosigmoid hernia. In addition, after a comprehensive review of PubMed and China National Knowledge Infrastructure, we present a review of 22 cases of transmesosigmoid hernia. We summarize several valuable clinical features that help early recognition of transmesosigmoid hernia. As a result of easy strangulation, in patients without a history of surgery or abdominal inflammation who present with symptoms of progressive or persistent small bowel obstruction (SBO), surgeons should consider the possibility of transmesosigmoid hernia. In addition, based on our data, in patients with SBO because of transmesosigmoid hernia, the defect is usually 2-5 cm in diameter. Furthermore, because of the high risk of strangulation with transmesosigmoid hernia, it is mandatory to reassess the condition timely and periodically when patients receive conservative treatment.
经乙状结肠系膜疝以往被认为是一种罕见疾病。其临床症状可能不具有特异性。在此，我们报告一例因经乙状结肠系膜疝导致的急性肠梗阻病例。此外，在全面检索PubMed和中国知网后，我们对22例经乙状结肠系膜疝病例进行了综述。我们总结了有助于早期识别经乙状结肠系膜疝的几个有价值的临床特征。由于易发生绞窄，对于无手术史或腹部炎症史且出现进行性或持续性小肠梗阻（SBO）症状的患者，外科医生应考虑经乙状结肠系膜疝的可能性。此外，根据我们的数据，因经乙状结肠系膜疝导致SBO的患者，缺损直径通常为2 - 5厘米。再者，由于经乙状结肠系膜疝发生绞窄的风险高，当患者接受保守治疗时，必须及时且定期重新评估病情。
