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通过计算机断层扫描诊断闭孔疝(“小老太太疝”):一例报告

Obturator hernia (the little old lady's hernia) diagnosed via computed tomography: a case report.

作者信息

Bohara Sujan, Karki Samikshya, Gautam Anu, Regmi Binit U, Rimal Sabin, Khadka Laxman, Pokharel Anuj, Gurung Bibek, Rawal Sushil B

机构信息

Departments of General and Gastrointestinal Surgery.

Spinal Injury Rehabilitation Center, Kavre, Nepal.

出版信息

Ann Med Surg (Lond). 2023 Apr 10;85(4):1282-1285. doi: 10.1097/MS9.0000000000000578. eCollection 2023 Apr.

Abstract

UNLABELLED

Obturator hernia is an infrequent clinical entity of abdominal wall hernia, accounting for an incidence rate ranging from 0.073 to 2.2% of all hernias and being responsible for 0.2-1.6% of all cases of mechanical intestinal obstruction. The computed tomography (CT) scan, as an imaging modality, is critical in improving the diagnostic rate of obturator hernia.

CASE PRESENTATION

The authors herein report an 87-year-old thin male patient with a known history of chronic obstructive pulmonary disease who presenting with complaints of abdominal pain for 3 days and constipation for 2 days, as well as one episode of vomiting without any features of peritoneal irritation, which was diagnosed early as a right-sided obturator hernia via CT and managed with exploratory laparotomy with hernia reduction and polypropylene mesh repair.

DISCUSSION

Obturator hernia is a rare surgical phenomenon with a varied clinical spectrum, ranging from asymptomatic to presenting as intestinal obstruction. The CT scan plays a critical role in the detection of obturator hernias, which ameliorates the possible significant postoperative morbidity and mortality.

CONCLUSION

This report demonstrates that a high index of suspicion combined with CT imaging aids in early diagnosis and management, thus overcoming the reluctant morbidity.

摘要

未标注

闭孔疝是一种罕见的腹壁疝临床病症,在所有疝中所占发病率为0.073%至2.2%,在所有机械性肠梗阻病例中占0.2% - 1.6%。计算机断层扫描(CT)作为一种成像方式,对于提高闭孔疝的诊断率至关重要。

病例介绍

本文作者报告了一名87岁消瘦男性患者,有慢性阻塞性肺疾病病史,主诉腹痛3天、便秘2天,并有一次呕吐,无任何腹膜刺激征,通过CT早期诊断为右侧闭孔疝,并接受了剖腹探查、疝还纳及聚丙烯网片修补术治疗。

讨论

闭孔疝是一种罕见的外科现象,临床表现多样,从无症状到表现为肠梗阻。CT扫描在闭孔疝的检测中起着关键作用,可降低术后可能出现的严重发病率和死亡率。

结论

本报告表明,高度的怀疑指数结合CT成像有助于早期诊断和治疗,从而克服难治性发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89be/10129172/5e46de63c05c/ms9-85-1282-g001.jpg

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