Hajong Ranendra, Khongwar Donkupar, Komut Ojing, Naku Narang, Baru Kappa
Associate Professor, Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India.
Assistant Professor, Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India.
J Clin Diagn Res. 2017 Aug;11(8):PD05-PD06. doi: 10.7860/JCDR/2017/27789.10370. Epub 2017 Aug 1.
Richter's hernia is due to the entrapment of a part of circumference of the bowel wall. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. Some patients with Richter's hernia may present with enterocutaneous fistula either spontaneous or due to surgical intervention mistaking the obstructed hernia to be inguinal abscess. This is more so in developing countries due to lack of awareness among the masses or due to the delay in seeking medical attention. Presenting here is a case of a 53-year-old male patient with enterocutaneous fistula which occurred spontaneously and sought medical attention only after about three years of repeated discharge of yellowish fluid from the left inguinal region. Magnetic resonance fistulogram confirmed the diagnosis of enterocutaneous fistula. Laparotomy with resection and primary anastomosis of the fistulous bowel was done. Patient recovered uneventfully without any complications or recurrence.
里氏疝是由于肠壁部分圆周被卡压所致。由于肠管连续性得以维持,患者通常不会出现肠梗阻。一些里氏疝患者可能会出现自发性肠皮肤瘘,或者因手术干预误将梗阻性疝当作腹股沟脓肿而导致肠皮肤瘘。在发展中国家,由于民众缺乏认识或就医延迟,这种情况更为常见。本文介绍一例53岁男性患者,其出现自发性肠皮肤瘘,仅在左侧腹股沟区反复流出淡黄色液体约三年后才就医。磁共振瘘管造影确诊为肠皮肤瘘。行剖腹手术,切除瘘管肠段并进行一期吻合。患者恢复顺利,无任何并发症或复发。