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全身麻醉诱导后自行回纳的嵌顿性腹股沟疝的疝镜检查

Hernioscopy in Incarcerated Inguinal Hernia Spontaneously Reduced after General Anesthesia Induction.

作者信息

White-Gittens Irwin C, Kalabin Aleksandr, Mani Vishnu R, Dinesh Anant, Sabbagh Raja

机构信息

Department of General Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital Center.

Department of Surgery, New York University School of Medicine, and the Laura and Isaac Perlmutter Cancer Center, Columbia University School of Physicians and Surgeons at Harlem Hospital Center.

出版信息

Cureus. 2017 Nov 15;9(11):e1849. doi: 10.7759/cureus.1849.

Abstract

Hernioscopy is essentially hernia sac laparoscopy. Hernia repair has evolved over the years with better outcomes; however, strangulated inguinal hernias are acute surgical emergencies which require emergent operative intervention. During anesthesia induction and/or after incision, hernia self-reduction is possible, with or without compromised bowel, back into the abdominal cavity. It is pivotal to examine the bowel to decide on further operative course. A simple alternative to unnecessary laparotomy or standard laparoscopy is hernioscopy, which is quite uncommon. We present a case of an acute symptomatic strangulated left-sided inguinal hernia which got self-reduced during anesthesia induction and was successfully repaired after hernioscopy was used to evaluate the incarcerated hernia content. We provide a brief review of literature about hernioscopy and an algorithm to guide surgeons in emergent cases.

摘要

疝镜检查本质上就是疝囊腹腔镜检查。多年来,疝修补术不断发展,效果越来越好;然而,绞窄性腹股沟疝是急性外科急症,需要紧急手术干预。在麻醉诱导期间和/或切开后,疝有可能自行回纳,无论肠管有无受损,均可回纳入腹腔。检查肠管以决定进一步的手术方案至关重要。疝镜检查是一种简单的替代不必要剖腹手术或标准腹腔镜检查的方法,但并不常见。我们报告一例急性有症状的左侧绞窄性腹股沟疝病例,该疝在麻醉诱导期间自行回纳,在使用疝镜检查评估嵌顿疝内容物后成功修复。我们简要回顾了有关疝镜检查的文献,并提供了一种算法,以指导外科医生处理急诊病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b429/5768316/bbc96fb72070/cureus-0009-00000001849-i01.jpg

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