Omameuda Takahiko, Shiozawa Mikio, Miyahara Yuzo, Kitabayashi Hiroyuki, Koizumi Masaru, Kondo Satoru, Kawai Shigeo, Kodama Masaaki
Department of Surgery, Tochigi Medical Center Shimotsuga, Ohiramachi Kawazure 420-1, Tochigi, Tochigi, 329-4498, Japan.
Department of Pathology, Tochigi Medical Center Shimotsuga, Ohiramachi Kawazure 420-1, Tochigi, Tochigi, 329-4498, Japan.
Surg Case Rep. 2023 May 29;9(1):91. doi: 10.1186/s40792-023-01676-x.
Linea alba hernias are relatively rare types of hernias. They manifest as small protrusions situated in the linea alba between the umbilicus and xiphoid cartilage. Usually, hernia contents comprise the pre-peritoneal fat, omentum, and gastrointestinal tract. However, very few cases of linea alba hernias involving the hepatic round ligament have been reported, to date.
An 80-year-old woman presented with upper abdominal pain and a 1-week history of a mass in the upper midline. Abdominal computed tomography revealed adipose tissue protruding from the abdominal wall contiguous with the hepatic round ligament, suggesting a linea alba hernia. During surgery, the hernial sac content was found to be a mass, which was resected. A linea alba hernia defect measuring 20 mm was repaired using a mesh. Histopathological findings revealed that the mass included mature adipocyte proliferation with broad fibrous septa, which was diagnosed as fibrolipoma of the hepatic round ligament.
We report the first case of a linea alba hernia involving fibrolipoma of the hepatic round ligament worldwide and describe the clinical features, diagnosis, and surgical procedure with a literature review.
白线疝是相对罕见的疝类型。它们表现为位于脐与剑突软骨之间白线处的小突起。通常，疝内容物包括腹膜前脂肪、大网膜和胃肠道。然而，迄今为止，很少有白线疝累及肝圆韧带的病例报道。
一名80岁女性因上腹部疼痛和上中线肿块1周病史就诊。腹部计算机断层扫描显示脂肪组织从与肝圆韧带相邻的腹壁突出，提示白线疝。手术中，发现疝囊内容物为一肿块，予以切除。使用网片修复了一个20毫米的白线疝缺损。组织病理学检查结果显示，肿块包括成熟脂肪细胞增生及宽纤维间隔，诊断为肝圆韧带纤维脂肪瘤。
我们报告了世界上首例累及肝圆韧带纤维脂肪瘤的白线疝病例，并结合文献复习描述了其临床特征、诊断及手术过程。
