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艾米安德疝:6 例 10 年经验。

Amyand's hernia: a 10-year experience with 6 cases.

机构信息

Department of Gastroenterology Surgery, The Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Southwest Road Shahekou District, Dalian, 116033, People's Republic of China.

Dalian Medical University, Dalian, 116044, Liaoning, People's Republic of China.

出版信息

BMC Surg. 2021 Jul 23;21(1):315. doi: 10.1186/s12893-021-01306-z.

Abstract

PURPOSE

Amyand's hernia is a rare hernia defined as an inguinal hernia that contains the appendix within the hernia sac. Current treatment of Amyand's hernia remains controversial. Our study retrospectively reviewed 6 cases of Amyand's hernia, aiming to provide a reference for the surgical treatment of Amyand's hernia.

METHODS

Six patients diagnosed with Amyand's hernia from September 2010 to May 2020 were retrospectively enrolled in our study. We summarized clinical data of six patients including the chief complaint, physical examinations, laboratory examinations, imaging examinations, surgical methods, and postoperative treatments and outcomes.

RESULTS

The diagnosis of six cases with Amyand's hernia was made during surgery. Two patients had normal appendixes whereas the remaining four patients had appendicitis. Two patients with normal appendix received tension-free mesh repair through the inguinal incision. Among those with inflamed or perforated appendixes, two received mesh repair and the other two did not. The discharge time after surgery of six patients was 9.8 ± 6.1 days. One patient suffered from a wound infection. No additional postoperative complications were detected.

CONCLUSIONS

Computed tomography and ultrasonography are helpful but limited in the definite diagnosis of Amyand's hernia. The presence of a normal appendix does not require to be resected, but appendicectomy is necessary if the appendix is inflamed. The treatment of Amyand's hernia should be tailored based on the patient's condition and the type of Amyand's hernia.

摘要

目的

Amyand 疝是一种罕见的疝,定义为疝囊内包含阑尾的腹股沟疝。目前 Amyand 疝的治疗仍存在争议。本研究回顾性分析了 6 例 Amyand 疝患者,旨在为 Amyand 疝的手术治疗提供参考。

方法

回顾性纳入 2010 年 9 月至 2020 年 5 月期间诊断为 Amyand 疝的 6 例患者。总结了 6 例患者的临床资料,包括主要症状、体格检查、实验室检查、影像学检查、手术方法、术后治疗及转归。

结果

6 例 Amyand 疝患者均在术中确诊。2 例阑尾正常,4 例阑尾炎。2 例阑尾正常患者经腹股沟切口行无张力补片修补术。4 例阑尾炎或穿孔患者中,2 例行补片修补,2 例未行修补。6 例患者术后出院时间为 9.8±6.1 天。1 例患者发生切口感染。无其他术后并发症发生。

结论

CT 和超声有助于诊断 Amyand 疝,但存在一定局限性。如果阑尾正常,无需切除,但如果阑尾炎,应行阑尾切除术。Amyand 疝的治疗应根据患者的病情和 Amyand 疝的类型而定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/592f/8305489/a610136f94f9/12893_2021_1306_Fig1_HTML.jpg

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