Alexandre Karlbuto, Vandeveer Zachary, Barnwell John M
Department of Surgery, Detroit Medical Center (DMC) Sinai-Grace Hospital, Detroit, USA.
Medicine, University of Medicine and Health Sciences, Basseterre, KNA.
Cureus. 2022 Oct 29;14(10):e30838. doi: 10.7759/cureus.30838. eCollection 2022 Oct.
This is the case of a 71-year-old male who presented to the emergency department with the chief complaint of left inguinoscrotal swelling and pain. The patient stated that he had nausea, vomiting, and constipation for a few weeks prior to the presentation. He also reported that he had a reducible, asymptomatic left inguinal hernia for the past 20 years. He began to experience pain in the left groin related to the hernia recently. During the past two weeks, he was having liquid bowel movements, and his last bowel movement occurred the morning of presentation. The patient did not report any fevers, chills, shortness of breath, or chest pain. His physical examination was remarkable for left lower quadrant fullness and mild abdominal distension. A large incarcerated left inguinoscrotal hernia was present, which markedly displaced and engulfed his penis. The patient was taken to the operating room for open inguinal hernia repair with mesh, where stomach and small bowel were encountered within the hernia sac. There was no ischemia noted, thus we repaired the hernia with mesh. The patient tolerated the procedure well and progressed postoperatively without incident. He was successfully discharged on postoperative day one. This case and literary review is a reference to the practicing general surgeon treating an incarcerated hernia containing the stomach.
这是一名71岁男性患者的病例,他因左侧腹股沟阴囊肿胀和疼痛为主诉就诊于急诊科。患者称在就诊前几周有恶心、呕吐和便秘症状。他还报告称,过去20年来一直患有可复性、无症状的左侧腹股沟疝。最近他开始感到与疝气相关的左侧腹股沟疼痛。在过去两周里,他一直有稀便,最后一次排便发生在就诊当天上午。患者未报告有发热、寒战、呼吸急促或胸痛。体格检查发现左下腹饱满,轻度腹胀。存在一个巨大的嵌顿性左侧腹股沟阴囊疝,该疝明显移位并包裹了他的阴茎。患者被送往手术室进行开放式腹股沟疝修补术并使用补片,术中在疝囊内发现了胃和小肠。未发现缺血情况,因此我们用补片修复了疝气。患者对手术耐受良好,术后恢复顺利,无并发症。术后第一天他成功出院。本病例及文献复习可供普通外科医生在治疗包含胃的嵌顿疝时参考。