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一种伪装且非常规的动力性肠梗阻病因:绞窄性闭孔疝。

A Masquerading and Unconventional Cause of Dynamic Intestinal Obstruction: Strangulated Obturator Hernia.

作者信息

Suresh Aneesh, Chinnakkulam Kandhasamy Sakthivel, Sahoo Ashok Kumar, Amaranathan Anandhi, Vishnu Prasad N R

机构信息

General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

出版信息

Cureus. 2018 Jan 29;10(1):e2124. doi: 10.7759/cureus.2124.

Abstract

Obturator hernia is an extremely rare type of abdominal wall hernia occurring mostly in elderly, thin females. It is characterized by the herniation of intra-abdominal contents through the obturator foramen. Symptoms are often nonspecific, and the patient usually presents with an acute or subacute intestinal obstruction. A high index of suspicion is needed in such females presenting with abdominal distention and positive Howship-Romberg signs. Computed tomography of the abdomen and pelvis are often necessary to arrive at a diagnosis, and immediate surgical intervention is recommended. The high postoperative morbidity and mortality are often attributed to a delay in the diagnosis and in initiating treatment. We present a case of a 65-year-old lady with strangulated obturator hernia who underwent emergent, lower midline laparotomy with resection and anastomosis of the small bowel and purse-string repair of the hernial defect.

摘要

闭孔疝是一种极为罕见的腹壁疝,多见于老年瘦弱女性。其特征是腹腔内容物通过闭孔疝出。症状通常不具特异性,患者常表现为急性或亚急性肠梗阻。对于出现腹胀且霍希普-龙伯格征阳性的此类女性,需要高度怀疑。腹部和盆腔计算机断层扫描通常是确诊所必需的,建议立即进行手术干预。术后高发病率和死亡率常归因于诊断和治疗启动的延迟。我们报告一例65岁患有绞窄性闭孔疝的女性患者,她接受了急诊下腹部正中剖腹术,包括小肠切除吻合术和疝缺损荷包缝合修补术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a871/5875977/20590f73285f/cureus-0010-00000002124-i01.jpg

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