Monib Sherif, Hamad Ahmed, Habashy Hany F
Breast Surgery, West Hertfordshire Hospitals NHS Trust, St. Albans and Watford General Hospitals, London, GBR.
Breast Surgery, University Hospitals of Derby & Burton, Derby, GBR.
Cureus. 2020 Dec 20;12(12):e12181. doi: 10.7759/cureus.12181.
Inguinal hernia is probably one of the most common surgical conditions, with strangulation accounting for a good number of acute surgical admissions. It has always been known that direct hernias are less likely to strangulate due to wide hernial defects in comparison to indirect hernia. For that reason, some surgeons do not attempt repair of direct hernias in elderly patients. We present a relatively uncommon case of a 58-year-old gentleman who presented with clinical signs of an incarcerated inguinal hernia; which was found at exploration to be a strangulated direct hernia with small bowel perforation. We believe that direct inguinal hernia should always be included in the differential diagnosis of incarcerated or strangulated groin hernia.
腹股沟疝可能是最常见的外科病症之一，绞窄性腹股沟疝占急性外科住院病例的相当一部分。一直以来都知道，与腹股沟斜疝相比，腹股沟直疝由于疝环缺损较大，发生绞窄的可能性较小。因此，一些外科医生不尝试为老年患者修复腹股沟直疝。我们报告一例相对罕见的病例，一名58岁男性患者出现腹股沟嵌顿疝的临床症状；术中发现为绞窄性腹股沟直疝伴小肠穿孔。我们认为，腹股沟嵌顿疝或绞窄疝的鉴别诊断应始终包括腹股沟直疝。
