一例创伤性腹壁疝合并迟发性肠梗阻。
A case of traumatic abdominal wall hernia with delayed bowel obstruction.
作者信息
Nishimura Takeshi, Nakao Atsunori, Okamoto Ayana, Fujisaki Noritomo, Kotani Joji
机构信息
Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
出版信息
Surg Case Rep. 2015 Dec;1(1):15. doi: 10.1186/s40792-015-0023-7. Epub 2015 Feb 11.
BACKGROUND
Traumatic abdominal hernia is rare and difficult to diagnose from physical symptoms.
PATIENT
A 60-year-old woman was admitted to the emergency department with complaints of vomiting after falling off a bicycle and hitting her abdomen against one of the handlebars 2 days earlier. Computed tomography (CT) demonstrated abdominal wall hernia from blunt trauma to the left upper abdomen. The patient underwent exploratory laparotomy, and the herniated bowel loop was not found to be perforated or gangrenous. Primary hernia repair without resection of the bowel loop was performed.
RESULTS
Postoperative course was uneventful.
CONCLUSION
Surgical exploration with primary repair of the defect is the definitive treatment in the present case, as the hernia contained an incarcerated loop of small bowel. The use of abdominal CT to confirm the diagnosis before operative repair of the hernia appears to be a safe and efficacious adjunct to physical examination.
背景
创伤性腹疝较为罕见，难以通过体格检查症状进行诊断。
患者
一名60岁女性因两天前从自行车上摔下，腹部撞到其中一个车把后出现呕吐症状而被收入急诊科。计算机断层扫描（CT）显示左上腹钝性创伤导致腹壁疝。患者接受了剖腹探查术，未发现疝出的肠袢有穿孔或坏疽。在未切除肠袢的情况下进行了一期疝修补术。
结果
术后病程顺利。
结论
在本病例中，由于疝内包含一段嵌顿的小肠，手术探查并对缺损进行一期修补是确定性治疗方法。在手术修补疝之前，使用腹部CT来确诊似乎是体格检查的一种安全有效的辅助手段。
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