Sueyoshi Koichiro, Inoue Yoshiaki, Sumi Yuka, Okamoto Ken, Azuma Daisuke, Yoshikawa Seiichiro, Fukunaga Masaki, Tanaka Hiroshi
Department of Emergency and Critical Care Medicine Juntendo University Urayasu Hospital Urayasu Chiba Japan.
Department of Emergency and Critical Care Medicine University of Tsukuba Tsukuba Ibaraki Japan.
Acute Med Surg. 2017 Jul 6;4(3):367-370. doi: 10.1002/ams2.288. eCollection 2017 Jul.
We report a rare case of omental herniation through the esophageal hiatus. A 46-year-old man visited our emergency department complaining of epigastralgia. Abdominal examination revealed muscular defense and rebound tenderness in his upper abdomen. A computed tomography scan showed a fat density mass in the posterior mediastinum. A laparoscopic operation was carried out under the diagnosis of omental herniation through the esophageal hiatus.
Abdominal pain disappeared dramatically after the operation. The postoperative course was uneventful.
Although a fat density mass in the posterior mediastinum is likely to be diagnosed as a lipomatous tumor, omental herniation through the esophageal hiatus should be taken into consideration as a possible diagnosis for acute abdominal pain in the emergency department.
我们报告一例罕见的经食管裂孔的网膜疝病例。一名46岁男性因上腹部疼痛就诊于我院急诊科。腹部检查发现其上腹部有肌紧张和反跳痛。计算机断层扫描显示后纵隔有一个脂肪密度肿块。在诊断为经食管裂孔的网膜疝后进行了腹腔镜手术。
术后腹痛显著消失。术后病程平稳。
尽管后纵隔的脂肪密度肿块很可能被诊断为脂肪瘤，但在急诊科对于急性腹痛，应考虑经食管裂孔的网膜疝作为一种可能的诊断。
