Foster Deshka, Nagarajan Sudhan, Panait Lucian
Department of Surgery, Drexel University College of Medicine, 245 N. 15th Street, Rm. 7150, Philadelphia, PA 19102, United States.
Int J Surg Case Rep. 2015;6C:160-2. doi: 10.1016/j.ijscr.2014.10.088. Epub 2014 Dec 11.
Abdominal wall hernias through the arcuate line termed Spigelian hernias are uncommon. These hernias presenting as a Richter-type, with strangulation of part of the circumference of the bowel wall is very rare.
We report a 27-year-old male patient who presented with a Richter-type Spigelian hernia.
A MEDLINE literature search of this rare entity yielded six publications presenting Richter-type Spigelian hernias. All of these articles and accompanying references were thoroughly reviewed. There was no gender or anatomical side predominance among the patients. All except our patient presented here were elderly. Pain was the most common symptom and was present in all patients. All patients underwent surgical repair and none reported recurrence of their hernia afterwards.
Richter-type Spigelian hernia is rare and has been reported infrequently in the existing literature. Clinical diagnosis is challenging and CT scan is the diagnostic study of choice. Surgical repair is the definitive treatment and involves primary or mesh repair of the defect as appropriate. Necrotic bowel should be resected and we recommend biologic mesh repair in these cases if the defect is large.
通过半月线的腹壁疝称为半月线疝，较为罕见。这些表现为里脱型（肠壁部分绞窄）的疝非常罕见。
我们报告一名27岁男性患者，其患有里脱型半月线疝。
对这一罕见病症进行的医学在线数据库（MEDLINE）文献检索得出六篇关于里脱型半月线疝的出版物。对所有这些文章及相关参考文献进行了全面审查。患者中不存在性别或解剖学侧别优势。除我们在此报告的患者外，所有患者均为老年人。疼痛是最常见的症状，所有患者均有此症状。所有患者均接受了手术修复，术后均未报告疝复发。
里脱型半月线疝罕见，现有文献中报道较少。临床诊断具有挑战性，CT扫描是首选的诊断检查方法。手术修复是确定性治疗方法，根据情况对缺损进行一期修复或使用补片修复。坏死肠段应切除，对于缺损较大的病例，我们建议使用生物补片修复。
