Department of Surgery, Grand Strand Medical Center, Myrtle Beach, SC, USA.
Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Am Surg. 2023 Aug;89(8):3646-3647. doi: 10.1177/00031348231173963. Epub 2023 Apr 29.
We present a rare case of perforated diverticulitis within an inguinal hernia sac adjacent to a synthetic mesh from a prior incisional hernia. An 80-year-old-female presented to the ED with abdominal pain. Cross-sectional imaging was significant for a small bowel obstruction with a transition point in the right lower quadrant (RLQ). On physical exam, the patient had palpable bilateral inguinal hernias that were reducible; however, after 48 hours of nonoperative management she failed to progress. Repeat imaging was concerning for incarcerated bowel within the inguinal hernia sac. She was taken to the operating room for exploratory laparotomy where the right inguinal hernia sac was found to contain sigmoid colon with diverticular perforation. A small bowel resection, right hemicolectomy and Hartmann's procedure were performed. The previously placed synthetic mesh was not contaminated during this operation and was not removed. Her hospital course was otherwise unremarkable but prolonged by the patient's deconditioned state.
我们报告了一例罕见的腹股沟疝囊内穿孔性憩室炎病例，该病例与先前切口疝的合成网片相邻。一名 80 岁女性因腹痛到急诊科就诊。横断面成像显示存在小肠梗阻，右下象限（RLQ）有一个过渡点。体格检查时，患者可触及双侧可复性腹股沟疝，但在非手术治疗 48 小时后，病情未见进展。再次影像学检查提示疝囊内肠管嵌顿。她被送往手术室进行剖腹探查术，术中发现右侧腹股沟疝囊内有乙状结肠憩室穿孔。行小肠部分切除术、右半结肠切除术和 Hartmann 手术。先前放置的合成网片在此次手术中未受污染，也未被移除。患者的住院过程无其他异常，但由于身体状况不佳而延长。
