Gosavi Rathin, Ban Ee
Department of Breast and Endocrine Surgery, Alfred Health, Melbourne, Victoria 3195, Australia.
J Surg Case Rep. 2020 Mar 2;2020(3):rjaa008. doi: 10.1093/jscr/rjaa008. eCollection 2020 Mar.
An internal hernia is a protrusion of viscera through a congenital or acquired defect in the mesentery of peritoneum. They account for <0.9% of all small bowel obstructions [1] and ~4% of obstructions due to hernias [2]. We present a rare case of closed loop obstruction secondary to a band adhesion traversing the lower abdomen from a sigmoid colon appendage epiploicae to the right pelvic wall. A 82-year-old woman presented to the emergency department with nausea, vomiting and worsening right sided abdominal pain for 24 h, on the background of previous pelvic radiation and hysterectomy for uterine cancer. She was subsequently found to have a closed loop obstruction with 30 cm of ischemic bowel strangulated by a band adhesion from a sigmoid colon appendage epiploicae to the right abdominal wall. The patient underwent a successful small bowel resection with primary anastomosis and made an uneventful recovery.
内疝是指内脏通过腹膜系膜的先天性或后天性缺损突出。它们占所有小肠梗阻的比例不到0.9%[1]，在疝导致的梗阻中约占4%[2]。我们报告一例罕见的闭袢性肠梗阻病例，其由一条从乙状结肠网膜附件至右盆腔壁横越下腹部的束带粘连所致。一名82岁女性因恶心、呕吐及右侧腹痛加重24小时就诊于急诊科，既往有盆腔放疗史及因子宫癌行子宫切除术。随后发现她患有闭袢性肠梗阻，30厘米的缺血肠段被一条从乙状结肠网膜附件至右腹壁的束带粘连绞窄。患者接受了成功的小肠切除及一期吻合术，术后恢复顺利。
