Malik Muhamamd Isfandyar Khan, Abbas Joshua, Shuttleworth Paul, Qureshi Nafees
General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
General Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK.
BMJ Case Rep. 2019 Nov 5;12(11):e231765. doi: 10.1136/bcr-2019-231765.
A 50-year-old man was referred to the emergency department by his general practitioner with a tender right-sided irreducible inguinal hernia (previously reducible), right-sided testicular pain and scrotal swelling. Clinical examination revealed a non-reducible, tender right inguinal-scrotal hernia and swollen right scrotum. Blood tests showed raised inflammatory markers. The patient went on to have a CT scan which was reported to show an indirect right inguinal-scrotal hernia possibly containing terminal ileum and small bowel mesentery. The scan also showed increased infiltrate changes within the hernia sac suggesting incarceration with possible early strangulation but no obvious evidence of bowel obstruction. The patient was taken to the operating theatre and found to have a large right inguinal-scrotal hernia containing pus and a perforated necrotic appendix. He went to have an appendicectomy and sutured repair of the hernia. Postoperatively, the patient made a good recovery and was discharged 2 days postsurgery.
一名50岁男性被其全科医生转诊至急诊科,患有右侧不可复性腹股沟疝(之前可复性)、右侧睾丸疼痛和阴囊肿胀。临床检查发现右侧腹股沟阴囊疝不可复且有压痛,右侧阴囊肿胀。血液检查显示炎症指标升高。患者随后进行了CT扫描,报告显示右侧腹股沟阴囊斜疝,可能包含回肠末端和小肠系膜。扫描还显示疝囊内浸润性改变增加,提示嵌顿并可能早期绞窄,但无明显肠梗阻证据。患者被送往手术室,发现右侧腹股沟阴囊疝巨大,含有脓液和穿孔坏死阑尾。他接受了阑尾切除术和疝修补缝合术。术后,患者恢复良好,术后2天出院。