Devarakonda Aneela, Gupta-Kaistha Aarav, Kulkarni Nikhil
Department of General Surgery, Lincoln County Hospital, Lincoln, UK.
J Surg Case Rep. 2020 Oct 31;2020(10):rjaa413. doi: 10.1093/jscr/rjaa413. eCollection 2020 Oct.
Obturator hernia is an extremely rare type of pelvic hernia with relatively high mortality and morbidity due to delayed diagnosis. Most cases present with acute intestinal obstruction and typically affect elderly, emaciated females. A high index of suspicion is required for early diagnosis and timely surgical intervention. We present a rare case of an 81-year-old female who was initially discharged from the emergency department due to nonspecific symptoms. She represented with clinical features of bowel obstruction and was diagnosed preoperatively with computed tomography imaging identifying a left-sided obturator hernia with a loop of bowel extending through the obturator canal. She was taken to theater for lower midline laparotomy and repair of obturator hernia. Although many cases are identified intraoperatively, we will discuss preoperative means of diagnosis of obturator hernia from examination findings to imaging diagnosis.
闭孔疝是一种极为罕见的盆腔疝,由于诊断延迟,其死亡率和发病率相对较高。大多数病例表现为急性肠梗阻,通常影响老年、消瘦的女性。早期诊断和及时的手术干预需要高度的怀疑指数。我们报告一例罕见病例,一名81岁女性最初因非特异性症状从急诊科出院。她出现肠梗阻的临床特征,术前通过计算机断层扫描成像诊断为左侧闭孔疝,一段肠管经闭孔管延伸。她被送往手术室进行下腹部正中剖腹术并修复闭孔疝。尽管许多病例是在术中发现的,但我们将从检查结果到影像诊断讨论闭孔疝的术前诊断方法。