Khalid Aizaz, Salman Mohamed A, Woodhams Simon, Newton Richard C
General Surgery, University Hospitals Sussex NHS Foundation Trust, Chichester, GBR.
Urology, University Hospitals Sussex NHS Foundation Trust, Chichester, GBR.
Cureus. 2023 Jun 1;15(6):e39837. doi: 10.7759/cureus.39837. eCollection 2023 Jun.
Small bowel obstruction is a common surgical pathology encountered in the emergency department. The most common cause of small bowel obstruction is adhesions secondary to previous abdominal surgery. While strangulated external hernias are also a common cause of obstructions encountered, internal hernias leading to obstruction are rare. We present a 76-year-old male who presented with an acute abdomen and was later diagnosed with an internal hernia underneath his right external iliac artery. Internal herniation underneath the iliac vasculature is a recent phenomenon encountered very rarely after the natural anatomy has been disturbed in patients who have undergone pelvic lymph node dissection. Patients with a previous history of pelvic lymph node dissection should be suspected of having an internal hernia if they present with an acute abdomen. Closure of the peritoneum should also be considered in these patients as it may help prevent herniation.
小肠梗阻是急诊科常见的外科病症。小肠梗阻最常见的原因是既往腹部手术后形成的粘连。虽然绞窄性外疝也是常见的梗阻原因，但导致梗阻的内疝很少见。我们报告一名76岁男性，他因急腹症就诊，后来被诊断为右髂外动脉下方存在内疝。髂血管下方的内疝是一种近期才出现的现象，在接受盆腔淋巴结清扫术且自然解剖结构受到干扰的患者中极为罕见。有盆腔淋巴结清扫术病史的患者如果出现急腹症，应怀疑有内疝。对于这些患者，还应考虑缝合腹膜，因为这可能有助于预防疝形成。
