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非典型股疝,又称 Laugier 疝:单中心的临床特征、影像学表现及治疗。

Atypical femoral hernia called Laugier's hernia: clinical features, radiological findings, and management at a single center.

机构信息

Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.

Department of Radiology, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.

出版信息

Langenbecks Arch Surg. 2020 Jun;405(4):445-450. doi: 10.1007/s00423-020-01897-w. Epub 2020 May 24.

Abstract

PURPOSE

Laugier's hernia is a rare clinical entity compared with a typical femoral hernia. Therefore, the clinical features, radiological findings, and appropriate treatment strategies remain largely unclear. In this study, we present 15 Laugier's hernia cases. Additionally, we review the relevant literature and discuss the clinical features, radiological findings, and appropriate treatment strategies pertaining to Laugier's hernia compared with a typical femoral hernia.

METHODS

Among 1260 hernia patients, we retrospectively enrolled 15 Laugier's hernia patients (1.19%) and 89 femoral hernia patients (7.06%) who underwent herniorrhaphy and compared the demographic characteristics and radiological findings between the two groups.

RESULTS

Regarding the patient characteristics, a significant difference was observed in the presence of pain (p < 0.001) and ileus symptoms (p = 0.001). Regarding the hernia characteristics, significant differences were observed in the size of the hernial sac (p = 0.001), contents of the hernial sac (p = 0.003), repositioning of the hernial sac (p < 0.001), and repair with polypropylene mesh (p < 0.001). The characteristic multi-detector computed tomography (MDCT) findings enabled the preoperative diagnosis of Laugier's hernia versus conventional femoral hernia.

CONCLUSION

Surgeons should be alert to the possibility of atypical femoral hernias while examining femoral hernia or inguinal hernia patients. If Laugier's hernia is suspected, preoperative MDCT is recommended.

摘要

目的

与典型股疝相比,Laugier 疝是一种罕见的临床实体。因此,其临床特征、影像学表现和适当的治疗策略在很大程度上仍不清楚。本研究报告了 15 例 Laugier 疝病例。此外,我们回顾了相关文献,并讨论了与典型股疝相比,Laugier 疝的临床特征、影像学表现和适当的治疗策略。

方法

在 1260 例疝患者中,我们回顾性纳入了 15 例 Laugier 疝患者(1.19%)和 89 例股疝患者(7.06%),这些患者均接受了疝修补术,并比较了两组患者的人口统计学特征和影像学表现。

结果

在患者特征方面,疼痛(p<0.001)和肠梗阻症状(p=0.001)的存在存在显著差异。在疝特征方面,疝囊大小(p=0.001)、疝囊内容物(p=0.003)、疝囊复位(p<0.001)和聚丙烯网片修补(p<0.001)存在显著差异。特征性多层螺旋 CT(MDCT)表现有助于术前诊断 Laugier 疝与传统股疝。

结论

外科医生在检查股疝或腹股沟疝患者时应警惕非典型股疝的可能性。如果怀疑 Laugier 疝,建议行术前 MDCT 检查。

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