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单侧经腹腹膜前修补术后双侧腹股沟膀胱疝。一例病例报告及文献复习。

Bilateral inguinal bladder hernia following unilateral transabdominal preperitoneal repair. A case report and review of the literature.

作者信息

AlMohaya Nasser, Alabdrabalameer Marwah Nasser E, AlAnazi Khalid, AlMuhsin Ahmed Mohammed, Eltomy Hesham

机构信息

Department of General Surgery, King Fahd Military Medical Complex, Dhahran, Saudi Arabia.

Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

出版信息

Ann Med Surg (Lond). 2019 Aug 21;46:23-26. doi: 10.1016/j.amsu.2019.08.005. eCollection 2019 Oct.

Abstract

Sliding hernia occurs when the hernia sac is partially formed by the wall of a viscus. The most common components of a sliding hernia includes the sigmoid colon, cecum, appendix, urinary bladder, and the ascending colon. However, the presence of bilateral vesical sliding hernia is rare and few cases have been reported in the literature. Patients with vesical sliding hernia may present with groin swelling with an associated lower urinary tract symptom. Computed tomography (CT) scan is the modality of choice for suspected cases which may reveal the classic pelvic micky mouse sign. The method of repair should be individualized taking in account the diagnostic findings. Although laparoscopic repair is becoming the mainstay management for inguinal hernia, the majority of sliding hernias are repaired using an open approach, which could be attributed to the presence of large hernias, associated complications, or recurrence with associated adhesions. We present a case of a 60-year-old male patient presented with bilateral inguinal swelling associated with urinary hesitancy and intermittency. He had undergone transabdominal preperitoneal (TAPP) repair for a left inguinal hernia 8 years ago. CT scan confirmed the presence of a bilateral hernia with the bladder herniating bilaterally. He underwent an elective bilateral open Lichtenstein tension-free mesh repair.

摘要

滑动疝是指疝囊部分由脏器壁构成。滑动疝最常见的组成部分包括乙状结肠、盲肠、阑尾、膀胱和升结肠。然而,双侧膀胱滑动疝较为罕见,文献报道的病例较少。膀胱滑动疝患者可能表现为腹股沟肿胀并伴有下尿路症状。计算机断层扫描(CT)是疑似病例的首选检查方式,可能显示典型的盆腔“米老鼠征”。修复方法应根据诊断结果个体化选择。虽然腹腔镜修复正成为腹股沟疝的主要治疗方法,但大多数滑动疝采用开放手术修复,这可能是由于疝块较大、存在相关并发症或伴有粘连的复发。我们报告一例60岁男性患者,表现为双侧腹股沟肿胀并伴有排尿犹豫和尿间断。他8年前因左侧腹股沟疝接受了经腹腹膜前(TAPP)修补术。CT扫描证实存在双侧疝,膀胱双侧疝出。他接受了择期双侧开放式Lichtenstein无张力疝修补术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1846/6717051/0f7798f9563d/gr1.jpg

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