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阔韧带疝的微创治疗:一例报告。

Less invasive treatment for broad ligament hernia: A case report.

作者信息

Sugishita Tetsuo, Kato Shunsuke, Ishikawa Aoi, Takahashi Hidenori, Kawachi Yasuyuki

机构信息

Department of Surgery, Musashino Red Cross Hospital, 1-26-1, Kyounanchou, Musashino-city, Tokyo, Japan.

Department of Surgery, Musashino Red Cross Hospital, 1-26-1, Kyounanchou, Musashino-city, Tokyo, Japan.

出版信息

Int J Surg Case Rep. 2020;73:172-175. doi: 10.1016/j.ijscr.2020.07.012. Epub 2020 Jul 15.

Abstract

INTRODUCTION

Among diseases that cause small bowel obstruction, internal hernia may result in severe outcomes. Therefore, emergency laparotomy has been often performed, but it may be invasive. We experienced a case of a broad ligament hernia of the uterus, which is relatively rare among the cases of internal hernia that were treated by less invasive laparoscopic surgery.

CASE PRESENTATION

A 71-year-old woman came to our hospital because of abdominal pain and vomiting. Abdominal computed tomography (CT) revealed a broad ligament hernia of the uterus without intestinal ischemia. Intestinal decompression was done by inserting an ileus tube (® Long Intestinal Tube, CLINY), followed by elective laparoscopic surgery.

DISCUSSION

If intestinal ischemia can be ruled out, a less invasive laparoscopic surgery may be performed after intestinal decompression. Further, by detecting the cause of internal hernia, more safe and smooth surgery can be performed. These findings highlighted the importance of accurate CT diagnosis.

CONCLUSION

In order to perform laparoscopic surgery for internal hernia, evaluation of the presence or absence of intestinal ischemia and detection of the cause of obstruction by preoperative abdominal CT are important.

摘要

引言

在导致小肠梗阻的疾病中,内疝可能会导致严重后果。因此,紧急剖腹手术经常被实施,但这可能具有侵入性。我们遇到了一例子宫阔韧带疝病例,在通过微创腹腔镜手术治疗的内疝病例中,这种情况相对少见。

病例介绍

一名71岁女性因腹痛和呕吐前来我院。腹部计算机断层扫描(CT)显示子宫阔韧带疝,无肠缺血。通过插入一根肠梗阻导管(®长肠管,CLINY)进行肠道减压,随后进行择期腹腔镜手术。

讨论

如果可以排除肠缺血,在肠道减压后可以进行微创腹腔镜手术。此外,通过检测内疝的病因,可以进行更安全、更顺利的手术。这些发现凸显了准确CT诊断的重要性。

结论

为了对内疝进行腹腔镜手术,通过术前腹部CT评估肠缺血的有无以及检测梗阻原因很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1483/7369453/2ed77e447d2e/gr1.jpg

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