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产后女性严重不可逆腹直肌分离和腹壁疝:罕见病例报告

Severe Irreversible Diastasis Recti Abdominis and Abdominal Hernia in Postpartum Women: Rare Case Report.

作者信息

Ha Won, Song Sin Young, Yoon Chi Sun, Kim Kyu Nam

机构信息

1 Department of Plastic and Reconstructive Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

2 Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Int Surg. 2016 Apr 22. doi: 10.9738/INTSURG-D-15-00204.1.

Abstract

Diastasis recti abdominis is a condition defined as the separation between the rectus abdominis and the linea alba, which leads to weakness in the abdominal muscles. Diastasis may be slight or severe, sometimes resulting in herniation of the abdominal viscera. Following childbirth, most women develop some extent of muscle separation in the postpartum period. However, if the diastasis recti abdominis in the postpartum period remain severe, it should be corrected to prevent concurrent abdominal hernia, strangulation or incarceration. We herein present two Korean cases of postpartum women with severe diastasis recti abdominis with abdominal hernia; it is the first report of its kind from Korea. Two women were referred to our clinic with severe abdominal bulge. Computerized tomography scan showed widening of the linea alba with abdominal hernia. The standard abdominoplasty with multiple wide longitudinal plications of the abdominal wall was performed in each patient under general anesthesia. There was no recurrence of diastasis recti abdominis or abdominal hernia during follow-up periods. The application of abdominoplasty in postpartum women with severe diastasis recti abdominis with abdominal hernia is thus considered to be an efficient management option. We hope these cases can provide a reference for the treatment of similar situations.

摘要

腹直肌分离是一种被定义为腹直肌与白线之间分离的病症,这会导致腹部肌肉无力。腹直肌分离可能轻微或严重,有时会导致腹腔脏器疝出。分娩后,大多数女性在产后会出现一定程度的肌肉分离。然而,如果产后腹直肌分离仍然严重,应进行纠正以防止并发腹疝、绞窄或嵌顿。我们在此报告两例韩国产后女性严重腹直肌分离伴腹疝的病例;这是韩国首例此类报告。两名女性因严重腹部膨隆被转诊至我们的诊所。计算机断层扫描显示白线增宽并伴有腹疝。在全身麻醉下,对每位患者进行了标准腹壁成形术,包括对腹壁进行多次宽纵行折叠。随访期间腹直肌分离或腹疝均未复发。因此,腹壁成形术应用于产后严重腹直肌分离伴腹疝的女性被认为是一种有效的治疗选择。我们希望这些病例能为类似情况的治疗提供参考。

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