Sasaki Noriyuki, Mitomo Shingo, Matsui Yusuke, Ishii Yugo, Sasaki Akira
Department of Surgery, Iwate Prefectural Ninohe Hospital, 38-2 Okawarage, Horino, Ninohe, Iwate 028-6193, Japan.
Department of Surgery, Iwate Prefectural Ninohe Hospital, 38-2 Okawarage, Horino, Ninohe, Iwate 028-6193, Japan.
Int J Surg Case Rep. 2023 Mar;104:107968. doi: 10.1016/j.ijscr.2023.107968. Epub 2023 Mar 8.
Morgagni-Larrey hernias (MLHs) are rare diaphragmatic hernias that can cause incarceration or strangulation of the hernia contents in some cases. Here we report a case of incarcerated Larrey hernia with small bowel obstruction, which was successfully treated with emergent laparoscopic surgery.
An 87-year-old woman presented to our hospital with abdominal pain and nausea. Computed tomography scan revealed an MLH comprising an obstructed intestinal loop. The patient underwent emergency laparoscopic surgery. Surgical findings showed incarceration of the small bowel on the left side of the falciform ligament. The small bowel was laparoscopically reduced and does not show signs of intestinal ischemia or perforation. The hernia orifice, which was approximately 15 mm in diameter, was closed with a surgical suture without the need for sac excision. The patient was discharged on postoperative day 7 without postoperative complications.
There are no established surgical techniques for the treatment of MLH due to its rarity. Our experience in the present case suggests that the laparoscopic approach might be considered as a feasible method even for incarcerated MLH.
Surgical techniques for MLH should be selected on a case-by-case basis.
莫尔加尼-拉里疝(MLH)是一种罕见的膈疝,在某些情况下可导致疝内容物嵌顿或绞窄。在此,我们报告一例嵌顿性拉里疝伴小肠梗阻的病例,该病例通过急诊腹腔镜手术成功治疗。
一名87岁女性因腹痛和恶心前来我院就诊。计算机断层扫描显示一个包含梗阻肠袢的莫尔加尼-拉里疝。患者接受了急诊腹腔镜手术。手术发现镰状韧带左侧小肠嵌顿。小肠经腹腔镜复位,未显示肠缺血或穿孔迹象。直径约15毫米的疝孔用手术缝线缝合,无需切除疝囊。患者术后第7天出院,无术后并发症。
由于莫尔加尼-拉里疝罕见,目前尚无既定的手术治疗技术。我们在本病例中的经验表明,即使对于嵌顿性莫尔加尼-拉里疝,腹腔镜手术方法也可被视为一种可行的方法。
莫尔加尼-拉里疝的手术技术应根据具体病例进行选择。