Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Surgery, Miyoshi Central Hospital, Hiroshima, Japan.
Clin J Gastroenterol. 2021 Apr;14(2):566-569. doi: 10.1007/s12328-020-01323-0. Epub 2021 Jan 15.
Falciform ligament hernia is a very rare internal hernia and is difficult to diagnose before surgery. We report a case of falciform ligament hernia with a specific symptom and image findings, which led to an accurate diagnosis and subsequent laparoscopic surgery. A 15-year-old adolescent boy with no previous medical history showed epigastric pain and was referred to our hospital. The abdominal pain was strong in the supine position and was alleviated in the knee-chest position. Contrast-enhanced computed tomography showed that the round ligament was recognized as a cord-like structure, and the mesentery of the small intestine was located at the cranioventral side of the ligament. He was diagnosed as having falciform ligament hernia, and emergency laparoscopic surgery was performed. The small intestine passed through the falciform ligament; however, it showed no sign of ischemia, and bowel resection was not required. The malposed intestine was repositioned, and the falciform ligament was cut to prevent hernia recurrence. The specific abdominal symptom and computed tomography image finding were useful to make the correct diagnosis in this case.
镰状韧带疝是一种非常罕见的内疝，术前难以诊断。我们报告了一例镰状韧带疝，其具有特定的症状和影像学表现，这有助于做出准确的诊断，并随后进行腹腔镜手术。一名 15 岁的青少年，既往无病史，表现为上腹痛，并被转至我院。仰卧位腹痛强烈，屈膝位缓解。增强 CT 显示圆韧带被识别为索状结构，小肠系膜位于韧带的头侧下方。他被诊断为镰状韧带疝，并进行了紧急腹腔镜手术。小肠穿过镰状韧带；然而，没有缺血的迹象，不需要肠切除术。将错位的肠复位，并切断镰状韧带以防止疝复发。在这种情况下，特定的腹部症状和 CT 图像表现有助于做出正确的诊断。
