Yatawatta Ashanga
Department of Surgery, University of Texas Medical Branch at Galveston, Galveston, Texas, USA.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-220475. doi: 10.1136/bcr-2017-220475.
Reduction en masse is reduction of a hernial sac into the pre-peritoneal space with a loop of bowel remaining incarcerated at the neck of the sac, leading to early strangulation. This is a rare complication, usually encountered with inguinal hernias, with a false reassurance to the patient and the treating physician that complete reduction has been achieved. Unless early intervention is carried out, this condition will typically present with worsening pain and absence of an appreciable hernia bulge at the groin, and intestinal necrosis may be encountered on exploration. The outcome will depend on the severity of peritonitis/sepsis, and mortality remains high for late presentations. A case of early presentation of reduction en masse of an inguinal hernia is reported with a review of the existing literature.
整块还纳是指将疝囊还纳入腹膜前间隙，而一段肠管仍嵌顿在疝囊颈部，从而导致早期绞窄。这是一种罕见的并发症，通常见于腹股沟疝，会给患者和治疗医生造成已完全还纳的错误假象。除非尽早进行干预，否则这种情况通常会表现为疼痛加剧且腹股沟处无明显的疝块隆起，探查时可能会发现肠坏死。其预后取决于腹膜炎/脓毒症的严重程度，晚期就诊者的死亡率仍然很高。本文报告了一例腹股沟疝整块还纳的早期病例，并对现有文献进行了综述。
