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巨大腹股沟疝:一例报告及手术技术综述

Giant inguinal hernia: Report of a case and reviews of surgical techniques.

作者信息

Trakarnsagna Atthaphorn, Chinswangwatanakul Vitoon, Methasate Asada, Swangsri Jirawat, Phalanusitthepha Chainarong, Parakonthun Thammawat, Taweerutchana Voraboot, Akaraviputh Thawatchai

机构信息

Minimally Invasive Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Minimally Invasive Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

出版信息

Int J Surg Case Rep. 2014;5(11):868-72. doi: 10.1016/j.ijscr.2014.10.042. Epub 2014 Oct 18.

Abstract

INTRODUCTION

Inguinal hernia is one of the most surgical common diseases. Giant inguinal hernia is more unusual and significantly challenging in terms of surgical management. It is defined as an inguinal hernia that extends below the midpoint of inner thigh when the patient is in standing position.

PRESENTATION OF CASE

A 67-year-old male presented with giant right-side inguinal hernia with symptoms of partial colonic obstruction and significant weight loss. Barium enema revealed ascending colon, cecum and ileum contained in hernia sac without significant lesions of large bowel. He underwent hernia repair with omentectomy. Hernioplasty with polypropylene mesh was performed without any complications. He recovered uneventfully.

DISCUSSION

There were several repair techniques suggested by published articles such as resection of the content and increased intraabdominal volume procedure. Many key factors for management of the giant inquinal hernia were discussed. A new classification of the giant inquinal hernia was described.

CONCLUSION

Surgical repair for the giant inquinal hernia is challenging and correlated with significant morbidity and mortality due to increased intra-abdominal pressure.

摘要

引言

腹股沟疝是外科最常见的疾病之一。巨大腹股沟疝较为少见,在手术治疗方面具有显著挑战性。它被定义为患者站立时腹股沟疝延伸至大腿内侧中点以下。

病例介绍

一名67岁男性因巨大右侧腹股沟疝就诊,伴有部分结肠梗阻症状和明显体重减轻。钡剂灌肠显示疝囊内包含升结肠、盲肠和回肠,大肠无明显病变。他接受了疝修补术并切除大网膜。采用聚丙烯网片进行疝成形术,未出现任何并发症。他恢复顺利。

讨论

已发表的文章提出了几种修复技术,如内容物切除和增加腹腔容积手术。讨论了巨大腹股沟疝治疗的许多关键因素。描述了一种新的巨大腹股沟疝分类方法。

结论

巨大腹股沟疝的手术修复具有挑战性,且由于腹内压升高与显著的发病率和死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a146/4245684/06ee6b16976b/gr1.jpg

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