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闭孔疝的诊断困难:1例罕见病例报告及文献复习

Diagnostic difficulties in obturator hernia: a rare case presentation and review of literature.

作者信息

Chitrambalam Tharun Ganapathy, Christopher Pradeep Joshua, Sundaraj Jeyakumar, Selvamuthukumaran Sundeep

机构信息

General Surgery, SRM Institute of Science and Technology, Kattankulathur, India

General Surgery, SRM Institute of Science and Technology, Kattankulathur, India.

出版信息

BMJ Case Rep. 2020 Sep 15;13(9):e235644. doi: 10.1136/bcr-2020-235644.

Abstract

Hernia arising from obturator canal is rare and it contributes to about less than 1% of incidence of all hernias. Diagnosing an obturator hernia clinically is a challenging one and nearly impossible. These hernias usually present as an intestinal obstruction as more than 50% of obturator hernias goes in for strangulation. Here, we report an unusual presentation of an obturator hernia in a 70-year-old woman who presented to emergency room with acute abdomen and uncomplicated reducible inguinal hernia. Radiological imaging showed obstructed inguinal hernia while on diagnostic laparoscopy, a strangulated and perforated obturator hernia of Richter's type was seen in addition to an uncomplicated inguinal hernia. Obturator hernia, although very rare, is associated with high morbidity and mortality as it is often underdiagnosed as in our case. Laparoscopy bailed us out from missing out a perforation from an occult obturator hernia.

摘要

闭孔疝很少见,占所有疝气发病率的不到1%。临床上诊断闭孔疝具有挑战性,几乎不可能。这些疝气通常表现为肠梗阻,因为超过50%的闭孔疝会发生绞窄。在此,我们报告一例70岁女性闭孔疝的不寻常表现,该患者因急腹症和无并发症的可复性腹股沟疝就诊于急诊室。放射学影像显示腹股沟疝梗阻,而在诊断性腹腔镜检查中,除了无并发症的腹股沟疝外,还发现了Richter型绞窄性穿孔闭孔疝。闭孔疝虽然非常罕见,但由于常常像我们的病例一样未被诊断出来,所以其发病率和死亡率很高。腹腔镜检查使我们避免漏诊隐匿性闭孔疝的穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19fc/7493113/ef1764151504/bcr-2020-235644f01.jpg

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