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闭孔疝:一例延迟诊断病例报告并文献复习

Obturator hernia: a delayed diagnosis. A case report with literature review.

作者信息

Siddiqui Zohaib, Khalil Mohammed, Khalil Aoff, Saeed Shuaib

机构信息

General Surgery, Maidstone & Tunbridge Wells NHS Trust, Tunbridge Wells, UK.

General Surgery, Medway NHS Trusty, Medway, UK.

出版信息

J Surg Case Rep. 2021 Jan 25;2021(1):rjaa599. doi: 10.1093/jscr/rjaa599. eCollection 2021 Jan.

Abstract

Obturator hernias are classically difficult to diagnose, have a high mortality and are an uncommon cause of intestinal obstruction. They are usually found in thin, elderly female patients. We present a case of a misdiagnosed 89-year-old female who presented to accident and emergency with a short history of abdominal pain. The diagnosis of an incarcerated obturator hernia was confirmed after re-discussion of computed tomography scan with the consultant radiologist in the morning. The patient underwent emergency laparotomy and the defect reduced. The patient recovered well post-operation; however; on the fourth day post-operation, the patient suffered a cardiac arrest. We report this case as a reminder to our health care colleagues to be mindful of elderly female patients who present with small bowel obstruction due to the high risk of mortality of this type of hernia.

摘要

闭孔疝传统上难以诊断,死亡率高,是肠梗阻的罕见病因。它们通常见于体型消瘦的老年女性患者。我们报告一例89岁女性误诊病例,该患者因腹痛病史较短就诊于急诊。经与放射科会诊医生于上午再次讨论计算机断层扫描结果后,确诊为嵌顿性闭孔疝。患者接受了急诊剖腹手术,缺损得到修复。患者术后恢复良好;然而,术后第四天,患者发生心脏骤停。我们报告此病例,以提醒我们的医护同行,要留意因这类疝死亡率高而出现小肠梗阻的老年女性患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e2e/7837359/b7fdcf4b01a2/rjaa599f1.jpg

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