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巨大滑动性膀胱腹股沟阴囊疝:一例报告并文献复习

Large sliding inguino-scrotal hernia of the urinary bladder: A case report and literature review.

作者信息

Wang Ping, Huang Yonggang, Ye Jing, Gao Guodong, Zhang Fangjie, Wu Hao

机构信息

Department of Hernia and Abdominal Wall Surgery, Hangzhou First People's Hospital, Hangzhou, China.

出版信息

Medicine (Baltimore). 2018 Mar;97(13):e9998. doi: 10.1097/MD.0000000000009998.

Abstract

RATIONALE

Sliding inguinal hernias of the urinary bladder are protrusions of the bladder through the internal inguinal ring, most of which are insignificant and diagnosed intra-operatively. Large inguino-scrotal bladder hernias commonly present with lower urinary tract symptoms and may cause severe complications, including bladder incarceration or necrosis, bladder hemorrhage, obstructive or neurogenic bladder dysfunction, and even renal failure.

PATIENT CONCERNS

We describe and discuss the clinical findings and management of a 59-year-old man who complained of a decrease in scrotal size after voiding and 2-stage voiding requiring pressure to the scrotum.

DIAGNOSES

The patient was diagnosed preoperatively as massive, bilateral, inguinoscrotal hernias, and a large, left-sided, sliding bladder hernia.

INTERVENTIONS

The patient underwent a timely open re-peritoneal inguinal herniorrhaphy using a mesh.

OUTCOMES

The surgical outcomes were good, and no surgical site infection, chronic postoperative inguinal pain or recurrence were recorded during the follow-up.

LESSONS

Better knowledge of this rare condition of large inguino-scrotal sliding bladder hernia could help in making a correct diagnosis preoperatively and provide proper surgical management timely, so as to reduce delay in treatment and avoid potential complications.

摘要

理论依据

滑动性腹股沟膀胱疝是膀胱通过腹股沟内环的突出,其中大多数无明显症状,在手术中被诊断出来。巨大腹股沟阴囊膀胱疝通常表现为下尿路症状,并可能导致严重并发症,包括膀胱嵌顿或坏死、膀胱出血、梗阻性或神经性膀胱功能障碍,甚至肾衰竭。

患者情况

我们描述并讨论一名59岁男性的临床表现及治疗情况,该患者主诉排尿后阴囊尺寸减小,且排尿分两阶段进行,需按压阴囊。

诊断

患者术前被诊断为巨大双侧腹股沟阴囊疝及左侧巨大滑动性膀胱疝。

干预措施

患者及时接受了使用补片的开放性腹膜前腹股沟疝修补术。

结果

手术效果良好,随访期间未记录到手术部位感染、术后慢性腹股沟疼痛或复发情况。

经验教训

更好地了解这种罕见的巨大腹股沟阴囊滑动性膀胱疝情况,有助于术前做出正确诊断,并及时提供恰当的手术治疗,从而减少治疗延误并避免潜在并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4acd/5895406/017a0db6f182/medi-97-e9998-g001.jpg

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