Sall I, Diémé E, Diallo M, Bénadji E, Diouf M, Ndiaye B, Fall O, Sow A, Diakhaté I C, Ogougbémy M
Department of digestive surgery, hôpital principal de Dakar, hôpital d'instruction des armées, 1, Nelson Mandela avenue, BP 3006, Dakar, Senegal.
Department of digestive surgery, hôpital principal de Dakar, hôpital d'instruction des armées, 1, Nelson Mandela avenue, BP 3006, Dakar, Senegal.
Morphologie. 2017 Jun;101(333):105-109. doi: 10.1016/j.morpho.2017.04.002. Epub 2017 May 17.
Hernia is described as the protrusion of an organ into the wall of its normal containing cavity. Internal hernia (IH) involves protrusion of viscera through: a peritoneal or mesentery defect, a normal or abnormal compartment of the peritoneal cavity. Hernias occurring in the pelvis cavity are usually classified according to the fascial margins breached and include sciatic, obturator and those through the rectouterin pouch: elytrocele and enterocele. Those hernias are defined by the protrusion of a viscus through the wall of the pelvis due to weakness of the pelvic fascia and/or muscles. Pelvic hernia through the pouch of Douglas (PD) involves the genital tract in female (elytrocele and enterocele). Sometimes described in the literature as Douglas hernia, this type of hernia must be distinguished from the conventional IH. As defined before, the borders to be considered for IH is the peritoneal membrane, which is not a real solid wall but delimitates the peritoneal cavity; and there is no peritoneal defect in elytrocele or enterocele. A PubMed search for IH through a defect in the peritoneal PD revealed only five female cases, making this an extremely rare condition. To our knowledge, we have presented here the only published case in a male. This probably congenital and morphologic anomaly (defect) of pouch of Sir Douglas must be distinguished as the real "Douglas IH". Authors discuss the concept of a new and more detailed classification of IH.
疝被描述为器官突出到其正常容纳腔的壁中。内疝（IH）是指内脏通过以下部位突出：腹膜或肠系膜缺损、腹膜腔的正常或异常腔隙。发生在盆腔的疝通常根据破裂的筋膜边缘进行分类，包括坐骨疝、闭孔疝以及通过直肠子宫陷凹的疝：阴道疝和肠疝。这些疝是由于盆腔筋膜和/或肌肉薄弱导致脏器通过盆腔壁突出而形成的。通过Douglas陷凹（PD）的盆腔疝在女性中涉及生殖道（阴道疝和肠疝）。这种类型的疝在文献中有时被描述为Douglas疝，必须与传统的内疝相区分。如前所述，内疝所考虑的边界是腹膜，腹膜并非真正的实体壁，而是界定腹膜腔；而阴道疝或肠疝不存在腹膜缺损。通过PubMed搜索经腹膜PD缺损的内疝，仅发现5例女性病例，这是一种极其罕见的情况。据我们所知，我们在此展示了唯一一例已发表的男性病例。这种可能先天性的Douglas陷凹形态异常（缺损）必须被视为真正的“Douglas内疝”。作者讨论了内疝新的更详细分类的概念。
