Yokoi Ryoma, Yamada Shigetoshi, Hatanaka Yuji, Kato Hiroki
Department of Surgery, Tajimi City Hospital, 3-43, Maebata, Tajimi, Gifu, 507-8511, Japan.
Surg Case Rep. 2021 Dec 7;7(1):252. doi: 10.1186/s40792-021-01334-0.
Bladder hernias are rare conditions that are difficult to diagnose preoperatively; many cases are diagnosed intraoperatively or postoperatively due to bladder injury. Most bladder hernias are direct inguinal hernias that involve the bladder in obese men older than 50 years old. We describe a rare case of a left femoral hernia involving the bladder in a young man.
A 32-year-old man with a bulge in the left inguinal region underwent laparoscopic transabdominal preperitoneal repair. Laparoscopy revealed a left indirect inguinal hernia. When the preperitoneal space was dissected toward the Retzius space along the vesicohypogastric fascia, the bladder was found to be protruding into the femoral ring and adhere to the hernial orifice severely. The bladder was reduced carefully without causing injury. After dissection, we repaired the left myopectineal orifice with a mesh. The patient was discharged on postoperative day 1 without complications. No recurrences or symptoms were noted at the 12-month follow-up.
A femoral hernia involving the bladder in a young man is rare. This case demonstrated that dissection along anatomical landmarks is important for preventing injuries to the bladder because even young men may have bladder hernias.
膀胱疝是一种罕见疾病,术前难以诊断;许多病例因膀胱损伤在术中或术后才得以诊断。大多数膀胱疝为直接腹股沟疝,多见于50岁以上的肥胖男性,且累及膀胱。我们报告一例年轻男性左侧股疝累及膀胱的罕见病例。
一名32岁男性,左侧腹股沟区有肿物,接受了腹腔镜经腹腹膜前修补术。腹腔镜检查发现为左侧腹股沟斜疝。当沿膀胱耻骨筋膜向Retzius间隙解剖腹膜前间隙时,发现膀胱突入股环并与疝孔严重粘连。小心将膀胱回纳,未造成损伤。解剖后,我们用补片修补了左侧肌耻骨孔。患者术后第1天出院,无并发症。12个月随访时未发现复发或症状。
年轻男性股疝累及膀胱罕见。该病例表明,沿解剖标志进行解剖对于预防膀胱损伤很重要,因为即使是年轻男性也可能发生膀胱疝。