Al Ani Amer Hashim, Hammami Mohammad Bakri, Adi Obaidah M Mukhles
Department of General Surgery, Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Int J Surg Case Rep. 2018;51:221-223. doi: 10.1016/j.ijscr.2018.08.026. Epub 2018 Aug 19.
Inguinal bladder hernias are rare incidents accounting for 1-3% of all inguinal hernia. Most of those cases are discovered intraoperatively accounting for the high incidence of bladder injuries during the repair. Symptoms can be variable depending on the size of the herniated bladder.
We present here a 70 years old obese male patient, with history of CVA & on regular Aspirin ingestion. He presented to the ER as a case of intestinal obstruction due to suspicion of strangulated inguinal hernia based on an unclear Ultrasound picture. He underwent an emergency exploration of the hernia where the balloon of a Foley's catheter was found inside a diverticulum of the urinary bladder, herniated through an Ogilvie hernia.
Ogilvie hernia is a rare incident that happens mostly in elderly males. The herniated part contains prevesical fat, bladder andor loops of intestines. Diagnosis must be made preoperatively through CT scan or Cystourethrogram. First line management involves surgical reduction of the bladder and hernia repair. Resection of the herniated part is generally limited to necrotic tissues.
Surgeons must have high index of suspicion for elderly obese males with inguinal hernias and urinary or intestinal obstruction symptoms. Careful preoperative planning must be made to avoid repair associated bladder injuries.
腹股沟膀胱疝较为罕见，占所有腹股沟疝的1% - 3%。这些病例大多在手术中被发现，这导致修复过程中膀胱损伤的发生率较高。症状可能因疝出膀胱的大小而异。
我们在此呈现一名70岁的肥胖男性患者，有脑血管意外病史且长期服用阿司匹林。他因疑似绞窄性腹股沟疝导致肠梗阻被送往急诊室，依据不清晰的超声图像诊断。他接受了疝的急诊探查，发现一根 Foley 导管的球囊位于膀胱憩室内，通过奥吉尔维疝疝出。
奥吉尔维疝是一种罕见情况，主要发生在老年男性。疝出部分包含膀胱前脂肪、膀胱和/或肠袢。术前必须通过CT扫描或膀胱尿道造影进行诊断。一线治疗包括膀胱手术复位和疝修补。疝出部分的切除一般限于坏死组织。
对于有腹股沟疝且伴有泌尿或肠梗阻症状的老年肥胖男性，外科医生必须有高度的怀疑指数。必须进行仔细的术前规划以避免修复相关的膀胱损伤。
