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复位后择期腹腔镜修补术可能是治疗嵌顿性闭孔疝的有效策略:一例病例报告

Elective laparoscopic repair after reduction might be useful strategy for incarcerated obturator hernia: a case report.

作者信息

Kohga Atsushi, Kawabe Akihiro, Cao Yuchen, Yajima Kiyoshige, Okumura Takuya, Yamashita Kimihiro, Isogaki Jun, Suzuki Kenji

机构信息

Division of Surgery, Fujinomiya City General Hospital, 3-1, Nishiki-cho, Fujinomiya, Shizuoka, Japan.

出版信息

J Surg Case Rep. 2017 Sep 21;2017(9):rjx180. doi: 10.1093/jscr/rjx180. eCollection 2017 Sep.

Abstract

Obturator hernia is a rare clinical condition that causes intestinal obstruction. Recent reports have suggested that laparoscopic repair may be useful for incarcerated obturator hernia in select patients. The patient was a 64-year-old female who presented to our emergency department with a chief complaint of abdominal pain. Computed tomography (CT) imaging revealed an incarcerated obturator hernia on her right side, without apparent findings of irreversible ischaemic change or perforation. She had a previous history of cardiovascular surgery and was taking an anticoagulant medication. We performed a reduction of the incarcerated intestine. After heparin displacement, laparoscopic repair was electively performed. During laparoscopy, an occult obturator hernia was found on the left side. We repaired the bilateral obturator hernia using a mesh prosthesis. Elective laparoscopic repair after reduction might be a useful procedure for incarcerated obturator hernias in those patients without findings of irreversible ischaemic change or perforation.

摘要

闭孔疝是一种导致肠梗阻的罕见临床病症。近期报告表明,腹腔镜修补术可能对部分嵌顿性闭孔疝患者有用。该患者为一名64岁女性,因腹痛为主诉前来我院急诊科就诊。计算机断层扫描(CT)成像显示其右侧存在嵌顿性闭孔疝,未发现明显的不可逆缺血性改变或穿孔迹象。她既往有心血管手术史,正在服用抗凝药物。我们对嵌顿的肠管进行了复位。在置换肝素后,择期进行了腹腔镜修补术。在腹腔镜检查过程中,发现左侧存在隐匿性闭孔疝。我们使用网片假体修复了双侧闭孔疝。对于那些未发现不可逆缺血性改变或穿孔迹象的嵌顿性闭孔疝患者,复位后择期进行腹腔镜修补术可能是一种有效的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd90/5610579/92730c868928/rjx180f01.jpg

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