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腹膜内补片修补术后的里氏疝

Richter's hernia after an intraperitoneal mesh repair.

作者信息

Pandey Anshuman, Masood Shakeel, Goel Vijay Kumar, Gupta Amit Kumar

机构信息

Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.

出版信息

Asian J Endosc Surg. 2014 Nov;7(4):330-3. doi: 10.1111/ases.12124.

Abstract

For ventral hernia repair, laparoscopic surgery offers various advantages, including the application of a large mesh using the intraperitoneal approach. However, improper closure of the port site may lead to serious complications. Port-site hernia is a rare outcome of inadequate repair of the fascial or peritoneal layer, and Richter's hernia in a high risk patient, in the presence of an intraperitoneal mesh, is a particularly challenging scenario. Herein, we present a 58-year-old woman who, after a ventral hernia repair, was diagnosed with a small bowel hernia through a 10-mm port site. The patient complained of pain and mild swelling at the port site in the postoperative period, and her symptoms indicated intestinal obstruction. Clinical evaluation and abdominal X-ray confirmed the diagnosis, and early laparoscopic re-exploration and management were the key to a favorable outcome.

摘要

对于腹疝修补术,腹腔镜手术具有多种优势,包括采用腹腔内入路应用大型补片。然而,切口部位关闭不当可能导致严重并发症。切口疝是筋膜或腹膜层修复不充分的罕见后果,而在腹腔内置入补片的情况下,高危患者发生里脱疝是一种特别具有挑战性的情况。在此,我们报告一名58岁女性,在腹疝修补术后,通过一个10毫米的切口部位被诊断为小肠疝。患者在术后期间主诉切口部位疼痛和轻度肿胀,其症状提示肠梗阻。临床评估和腹部X线检查确诊了病情,早期腹腔镜再次探查和处理是取得良好预后的关键。

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