Misseldine Adam, Kircher Cole, Shebrain Saad
Department of General Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, USA.
Cureus. 2020 Dec 27;12(12):e12327. doi: 10.7759/cureus.12327.
We report a case of a giant inguinal hernia (GIH) that underwent open surgical repair with mesh. The patient had a massive transcompartmental redistribution of abdominal contents from the abdominopelvic cavity to the hernia sac in the scrotum, with subsequent effects on the mechanical nature of the abdominal wall muscles. Repair of this type of giant hernia is challenging as it can raise the intra-abdominal pressure, therefore increasing the risk of abdominal compartment syndrome (ACS). The large size and chronicity of the hernia, associated with deranged mechanical forces/properties of the abdominal wall, made the management of this complex case unique and interesting. In similar cases of massive incisional or ventral hernias, the term "loss of domain" (LOD) is used. In such types of massive hernias, it is important to carefully plan and monitor for adverse physiological effects associated with increased abdominal pressure.
我们报告一例巨大腹股沟疝（GIH）患者，该患者接受了开放手术加补片修补术。患者腹腔内容物大量跨腔重新分布，从腹腔盆腔进入阴囊内的疝囊，随后对腹壁肌肉的力学性质产生影响。修复这种类型的巨大疝具有挑战性，因为它会升高腹内压，从而增加腹腔间隔室综合征（ACS）的风险。疝的巨大尺寸和慢性病程，以及腹壁机械力/特性紊乱，使得该复杂病例的处理独特且有趣。在类似的巨大切口疝或腹疝病例中，会使用“领域丧失”（LOD）这一术语。在这类巨大疝中，仔细规划并监测与腹压升高相关的不良生理影响非常重要。
